Dover – The Delaware Department of Health and Social Services (DHSS) announced progress in the battle against cancer in the first state. The DHSS Cancer Incidence and Mortality report for the years 2005-2009 is the most comprehensive cancer data report in the state. And, the most recent data demonstrate that Delaware continues to make progress in fighting cancer, particularly cancer mortality.
In the 1990s, Delaware had the second highest cancer mortality in the country. Under the leadership of the Delaware Cancer Consortium and numerous health partners, that number has dropped significantly since then. In last year’s report (from years 2003-2007), Delaware was ranked 12 and now the state ranking has fallen further to 14.
“Delaware is making progress by focusing on a three-pronged strategy: prevention, screening and treatment,” said Governor Jack Markell. “But the fight is far from over. We cannot be satisfied until we end cancer altogether.”
DHSS Secretary Rita Landgraf praised the coordinated work of the Delaware Cancer Consortium, the Delaware Health Fund Advisory Committee, the Governor’s Council on Health Promotion and Disease Prevention and others in informing and educating Delawareans on preventing disease by making better lifestyle choices.
“A main message today is the importance of prevention and to remind people there are things they can do to reduce their cancer risk,” said DHSS Cabinet Secretary Rita Landgraf. “One of the simplest changes anyone can make is quitting smoking. Lung cancer is responsible for an astonishing 30 percent of Delaware’s cancer deaths and this simple step could save your life.”
Dr. Karyl Rattay, Director of the Division of Public Health, highlighted the importance of reducing additional behavior risk factors: obesity, poor diet, inactivity, alcohol abuse, and exposure to UV light—all which can increase cancer risk.
“The cancer data are encouraging, but if we want to reduce the overall incidence of all cancers and further lower mortality, we all must focus on the things we can control, our lifestyle,” said Dr. Rattay. “An easy to remember healthy lifestyle slogan is ‘5-2-1 Almost None’: five or more fruits or vegetables daily, no more than two hours of recreational screen time, one hour of total physical activity a day and almost no sugary beverages. Research shows lifestyle improvements matter.”
Delaware made progress in incidence or mortality in several areas:
- INCIDENCE RATES – Important incidence declines were seen for several cancers: including ovary, larynx, colon, cervix, esophagus, stomach and Hodgkin lymphoma —all of which experienced a larger drop than the nation.
- COLORECTAL CANCER – For the first time, colorectal cancer incidence was significantly lower among African Americans in Delaware than nationally; for both sexes combined; and for females. In the 10-year period, Delaware’s colorectal cancer mortality rate decreased 28.9 percent, compared to 22.7 percent nationally. This improvement in mortality is attributable to greater awareness of the necessity of colorectal screenings, and the provision of them through the Screening for Life program.
- RACIAL DISPARITY CLOSED IN SCREENINGS: Delaware became the first state in the country to end a racial disparity for colorectal screening. In 2010, a higher percentage of African-American Delawareans were screened (74.9 percent) than whites (74 percent). Delaware’s colorectal incidence rate declined 22.6 percent, while the U.S. rate declined 16.6 percent. In Delaware, the greatest improvement in incidence was made among African-American females (30.4 percent decline).
- FEMALE BREAST CANCER – Thanks to the improvement in the early detection of breast cancer, the decline in the breast cancer death rate for all Delaware women (29 percent) was over 50 percent greater than the decline nationally (19 percent) over the 10-year period. Delaware women ranked second (tied with two other states) nationally in the prevalence of women 40 and older who have had a mammogram within the past two years (81.4 percent). Between the two periods, there was a 9 percent decrease in breast cancer incidence among white females.
- MAJOR IMPROVEMENTS IN MORTALITY– Nine cancer types have shown considerable improvements in mortality (over the past 10 rolling five-year time periods):
o cervix (54.3 percent decline),
o prostate (35.0 percent),
o colon and rectum (29.0 percent),
o female breast (29.0 percent),
o stomach (25.5 percent),
o oral cavity and pharynx (25.2 percent),
o esophagus (23.7 percent)
o larynx (22.0 percent), and
o Non-Hodgkin lymphoma (22.2 percent).
But challenges remain:
- INCIDENCE RATES – Compared to 10 years earlier, Delaware’s 2005-2009 overall cancer incidence rates were the same as 1995-1999. In 2005-2009, Delaware’s incidence rates for cancers of the colon, lung, prostate, thyroid, bladder, uterus and skin (malignant melanoma) were significantly higher than the U.S. rate. The cancers with dramatic incidence rate increases in Delaware and nationally during the 10-year period are: liver, thyroid, kidney and skin (malignant melanoma).
- LUNG CANCER – Lung cancer continues to play an enormous role in Delaware’s overall cancer burden. In 2005-2009, lung cancer accounted for 15.2 percent of all newly diagnosed cancer cases and 30.3 percent of all cancer deaths in Delaware.
- FEMALE BREAST CANCER – Breast cancer incidence among African-American women increased 4.6 percent. African-American women did have a significantly lower death rate then the U.S. (22.6 per 100,000 compared 31.6 per 100,000 nationwide).
- PROSTATE CANCER – Most likely because of a greater prevalence of prostate cancer screening in Delaware compared with the rest of the country, Delaware’s incidence rate increased 5 percent over the past 10 years, compared with a 10.7 percent decrease nationally. The burden disproportionately affects African-American men in Delaware and the nation. Delaware’s 2005-2009 incidence rates were 80 percent higher for African Americans than for whites.
By law, the Delaware Division of Public Health analyzes cancer rates by census tracts. Of Delaware’s 214 census tracts, the overall cancer incidence rates were not significantly different from the state’s average rate in 189 tracts. The overall cancer incidence rate was statistically significantly higher than Delaware’s average 2005-2009 incidence rate in nine census tracts; and in 16 census tracts, it was significantly lower. The rates between census tracts may differ for a variety of reasons including a clustering of lifestyle behaviors such as smoking, unhealthy eating and lack of physical activity; environmental or occupational exposure to chemicals or a lack of such exposure; access to health care, including screenings; and chance or random variation. And, also calculation can be impacted by the inherent instability of rates due to small numbers of cancer cases and small populations in certain census tracts.
The 2005-2009 cancer data report is posted on DPH’s website at this address: http://www.dhss.delaware.gov/dhss/dph/dpc/cancer.html. DPH will arrange presentations about cancer rates, risks and prevention methods for community groups who call 302-744-1040.
For information on quitting smoking, call toll-free:1-866-409-1858. To learn if you qualify for free cancer screenings or treatment, call the Delaware Helpline 2-1-1.
*Data are presented as five-year rolling averages to reduce the impact that short-term fluctuations may have due to the small size of Delaware’s population.
Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.
# # #