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Delaware cancer rates down but still above national rate

Cancer rates in Delaware fell in recent years thanks to better screening and treatment programs but remain above national levels largely because of poor lifestyle choices, the Department of Health and Social Services said on Wednesday.

Deaths from the disease in the state dropped 18 percent between 1993-97 and 2003-07, outpacing a national decline of 12.1 percent over the same period.

But Delaware’s overall cancer mortality rate of 193.5 per 100,000 persons in the latest period was much higher than the U.S. rate of 183.8, giving Delaware the 12th-highest mortality rate for all cancers among U.S. states.

That’s an improvement from the ranking as the second-highest cancer mortality rate in the nation a decade ago, but more needs to be done, particularly on reducing preventable lifestyle risks, officials said.

The state’s higher rate reflects risk factors such as obesity, inactivity, poor diets and particularly cigarette smoking that have deteriorated or failed to show much improvement in recent years, said Dr. Karyl Rattay, director of the Division of Public Health.

Twenty percent of Delawareans smoke, a rate that was falling but has recently leveled off and may be starting to climb again. As a result, the state’s lung cancer rate is almost 30 percent higher than the national rate. More people die from lung cancer in Delaware than from any other form of the disease, Dr. Rattay said.

The statewide obesity rate has more than doubled to 30 percent today from 14.4 percent in 1990, while 40 percent of children and 64 percent of the overall population are either overweight or obese, increasing those people’s risk of getting cancer, Dr. Rattay said.

“We continue to go the wrong way on obesity,” she said in an interview with DFM News. Added to concerns over unhealthy diets and a lack of exercise, Delaware has a lot of work to do to reduce those risk factors.

“One of our greatest challenges remains healthy lifestyles,” she said.

In the latest period, the number of men dying from cancer declined 22.4 percent compared with a national decline of 15.7 percent while that for women fell 15.2 percent compared with a drop of 10.9 percent nationwide.

Between 2003 and 2007, a total of 23,509 cases of cancer were diagnosed in Delaware, of which 8,926 patients died from the disease. Of the fatalities, 52 percent were male and 48 percent female. The highest incidence rates are in prostate cancer for men and breast cancer for women.

For breast cancer, Delaware’s mortality rate fell 26.4 percent, exceeding a decline of 20.3 percent nationally.

“If the trend continues, Delaware’s breast cancer mortality rate may soon be significantly lower than the national rate,” the DHSS report said.

The biggest decline in the overall incidence of cancer occurred among black men where the rate fell 17.5 percent, the DHSS said in its report “Cancer Incidence and Mortality in Delaware 2003-2007”.

Among the improvements cited by medical authorities is the narrowing disparity between racial groups. Because of improved education and screening, Delaware has eliminated the disparity between the incidence of colorectal cancer among African Americans and the rest of the population, and significantly narrowed the cancer mortality gap between racial groups. (More coverage of Delaware’s progress on colorectal cancer can be found here.)

The state’s decline in overall cancer rates can be attributed to better screening and treatment, Dr. Rattay said. Delaware is the only state in the nation that makes cancer treatment available to everyone, even if they are uninsured or underinsured. To qualify for cancer treatment that’s not covered by insurance, a patient’s income must be 650 percent of the federal poverty level or less, she said.

By various measures, Delaware’s cancer rates were higher than those of the country as a whole. The incidence rate of all-site cancers, for instance, was 7.8 percent higher than the national figure, while the state’s breast cancer rate among black women, at 132.1 per 100,000, was significantly higher than the U.S. rate of 119.3, the report said.

The state’s incidence of colorectal and prostate cancers was higher than national rates while the local rate of lung/bronchus cancer exceeded the U.S. mark by 28.5 percent.

Fifty-nine census tracts had significantly higher cancer rates than the statewide average, possibly due to a concentration of lifestyle behaviors such as smoking; environmental or occupational exposures to chemicals, and access to healthcare, including screenings.

To increase public understanding of cancer risks, health officials are mailing information sheets to targeted neighborhoods making residents aware of the incidence of the disease in their locality.

In an attempt to reverse the deterioration in the lifestyle factors that increase cancer risk, the state health officials plan to step up public education campaigns in schools, offices and public buildings.

For people who want to get screened or treated, cancer care coordinators have been appointed in hospitals to make patients aware of the services that are available to them.
DHSS Secretary Rita Landgraf said a number of agencies and health-education bodies have been encouraging the prevention of cancer through healthy lifestyles, and providing screening and treatment services.

“At no time in our state’s history have so many health partners worked in synchronization to help every Delawarean access cancer screenings or treatment, or to receive additional cancer information,” Landgraf said.

But whatever further progress is made in combating cancer, it’s not likely to be rapid, said Dr. Nicholas Petrelli, Medical Director of Christiana Care’s Helen F. Graham Cancer Center, at a news conference.

“It’s not an overnight fix,” he said.