DOVER – Cancer screening and early detection efforts continue to drive down Delaware’s all-site cancer mortality rates, say Delaware public health officials. From 2000-2004 to 2010-2014, Delaware’s cancer death rate decreased 12 percent, an impressive improvement though slightly lower than the decline seen nationally (14 percent), according to the latest cancer data announced by the Division of Public Health (DPH).

DPH presented its new report, Cancer Incidence and Mortality in Delaware, 2010-2014 to the Delaware Cancer Consortium (DCC) following its meeting today in Dover. The annual report provides data for all cancer sites combined (all-site cancer), 23 site-specific cancer types, risk factors, early detection and screening recommendations, and census tract maps.

Delaware ranks 16th nationally for all-site cancer mortality, which remains unchanged from last year’s report, but is two slots lower than 14th highest two years ago, which looked at the 2008-2012 time period. Delaware’s current ranking still represents considerable continued progress since the 1990s, when the state ranked second for all-site cancer mortality.

Delaware’s all-site cancer mortality rate fell 15 percent among men, 9 percent among women, 21 percent among African Americans, 14 percent among Caucasians, and 2 percent among Hispanics over the last decade, according to the report. Despite continuing decreases, at 178.2 deaths per 100,000 people, the state’s mortality rate was still 7 percent higher than the U.S. rate of 166.1 for 2010-2014. The DCC and DPH are committed to continuing efforts to reduce Delaware’s cancer mortality rate.

Regarding incidence, or diagnosis of new cancer cases, Delaware’s 2010-2014 all-site cancer incidence rate (506.4 diagnoses per 100,000) was 14 percent higher than the comparable U.S. rate. Despite fluctuations in all-site cancer incidence between the 2000-2004 to 2010-2014 time periods, Delaware’s 2010-2014 all-site cancer incidence rate was unchanged from 2000-2004 (506.3 per 100,000).

While Delaware is ranked second among states for highest all-site cancer incidence, the state’s continued success in early detection and screening efforts play a key role in these rates. All-site cancer incidence fell 5 percent among men but increased by 5 percent in women. It also decreased by 9 percent among African Americans, 12 percent among Hispanics, but increased by 2 percent among Caucasians. Part of the increase in female cancer incidence may be due to increased screening efforts by DPH; Delaware is ranked second nationally in breast cancer screening (mammography).

“Delaware is making great progress in battling the deadly disease of cancer in our state,” said Governor John Carney. “This report shows our successes, but also shows us we have more work to do, particularly when it comes to reducing cancer incidence. As an original member of the Delaware Cancer Consortium, I want to thank the strong network of cancer advocates in our state for their important partnership on this issue, particularly the Department of Health and Social Services Division of Public Health, the Consortium, and our many statewide and community champions for the daily work they do to improve access to screening and treatment for all Delawareans.”

Today, DPH also issued the supplementary report, Disparities in Cancer Incidence and Mortality Among Delaware Residents, 2010-2014, which addresses disparities in cancer in the state. According to the Disparities report, Hispanics had statistically significantly lower incidence rates for all-site cancer compared to both Caucasians and African Americans. This was also true when comparing Hispanic males and females specifically to Caucasian and African-American males and females in this category. African-American females had significantly lower all-site cancer incidence rates compared to Caucasian females.

African-American females also had significantly lower incidence and mortality rates for lung cancer, compared to Caucasian females. Hispanics in general, and Hispanic males in particular, had significantly lower lung cancer incidence rates compared to their counterparts of Caucasian and African-American ethnicity. African-American males, particularly those between 40 and 74 years of age, had significantly higher incidence and mortality rates for prostate cancer compared to Caucasian males of similar ages.

“I’m pleased that we are seeing some successes, particularly in the African-American and Hispanic communities,” said Dr. Kara Odom Walker, Cabinet Secretary of the Delaware Department of Health and Social Services (DHSS). “However, there is still more we need to do to eliminate disparities for African Americans, particularly when it comes to earlier diagnosis of lung cancer in men.”

“While we continue to make progress in screening more Delawareans and detecting cancer earlier, it’s time for us to make a shift in our approach to reducing cancer incidence and mortality,” said DPH Director Dr. Karyl Rattay. “We know that if we really want to move the needle in this area, we need to increase our focus on prevention, screening, and addressing upstream issues such as tackling lifestyle factors that contribute to cancer risk such as obesity and lack of physical activity.”

To accomplish this, DPH plans to increase its prevention efforts, making it easier for Delawareans to improve their health and reduce their risk of cancer. This includes working with communities so they can focus on the their most important barriers to making healthy lifestyle choices such as not smoking, engaging in regular physical activity, eating a healthy diet and maintaining a healthy weight. DPH will focus on implementing strategies that will “make the healthy choice the easy choice” for all Delaware residents.

DPH officials also acknowledge that there is still much more work to be done regarding specific cancer types. Of particular concern is lung cancer, which is the most frequently diagnosed cancer in the nation and in Delaware. Lung cancer continued to account for 14 percent of all newly diagnosed cancer cases and 30 percent of all cancer deaths in Delaware from 2010 to 2014. Most lung cancer cases are diagnosed in the distant stage, when the cancer has spread to distant tissues, organs, or lymph nodes.

In the coming year, the DPH Comprehensive Cancer Control program will focus its outreach efforts on educating consumers and providers about the importance of lung cancer screening for high-risk groups and will collaborate with the DPH Tobacco Prevention and Control program on cessation efforts and proactive policies. According to the U.S. Department of Health and Human Services, 85 percent to 90 percent of lung cancers are caused by tobacco use. Though cigarette smoking prevalence among Delaware adults was at an all-time low of 18 percent, according to the 2016 BRFS, it remains largely unchanged over the last four years.

Both reports, in addition to a secondary analysis report of census tracts with higher incidence of cancer, can be viewed in full here.

Breast Cancer
· Female breast cancer mortality in Delaware decreased 15 percent over the last decade (2000-2004 to 2010-2014), slightly lower than the 17 percent decline seen nationally.
· From 2000-2004 to 2010-2014, the breast cancer incidence rate decreased by 9 percent among Hispanic females in Delaware.
· The proportion of breast cancer cases diagnosed in the earliest, most treatable stage has greatly improved in Delaware over the past three decades. The proportion of Delaware breast cancers diagnosed at the local stage increased from 42 percent in 1980-1984 to 67 percent in 2010-2014.

Colorectal Cancer
· From 2000-2004 to 2010-2014, Delaware’s colorectal cancer incidence rate decreased 31 percent, a higher decrease than the comparable U.S. rate (23 percent).
· Ranked 35th nationally, Delaware’s colorectal cancer incidence rate of 37.8 diagnoses per 100,000 was lower than the U.S. rate of 40.1 per 100,000.
· From 1980-1984 through 2010-2014, the percentage of colorectal cancers diagnosed at the local stage increased from 32 percent to 38 percent.
· From 2000-2004 to 2010-2014, Delaware’s colorectal cancer mortality rates declined 50 percent among non-Hispanic African-American males, compared to 28 percent among non-Hispanic Caucasian males. During the same time period, colorectal cancer mortality declined 55 percent among non-Hispanic African American females, compared to 31 percent among non-Hispanic Caucasian females.

Liver Cancer
· From 2010-2014, Delaware’s liver cancer incidence rate of 8.7 diagnoses per 100,000 was similar to the U.S. rate of 8.6 per 100,000.
· From 1980-1984 through 2010-2014, Delaware’s percentage of liver cancer cases diagnosed at the local stage increased substantially from 15 percent to 41 percent.

Lung Cancer
· From 2000-2004 to 2010-2014, Delaware’s lung cancer incidence rate decreased 8 percent. The national incidence rate decreased 12 percent.
· From 2000-2004 to 2010-2014, Delaware’s lung cancer mortality rate declined 14 percent. The national mortality rate declined 18 percent.
· From 2000-2004 to 2010-2014, Delaware’s lung cancer mortality rates declined 32 percent among non-Hispanic African-American males and 25 percent among non-Hispanic African- American females.

Prostate Cancer
· From 2000-2004 to 2010-2014, prostate cancer mortality in Delaware declined 31 percent, which is slightly higher than the decrease seen nationally (29 percent).
· Between 2000-2004 and 2010-2014, prostate cancer incidence rates in Delaware decreased by 18 percent.
· From 1980-1984 through 2010-2014, Delaware’s percentage of prostate cancer cases diagnosed in the local stage increased substantially, from 50 percent to 79 percent.

Those seeking lung cancer screenings should visit HealthyDelaware.org/lung or call 302-401-4212 to speak with a screening nurse navigator. Delaware tobacco users seeking help quitting can contact the Delaware Quitline, a free tobacco cessation counseling hotline for residents 18 and older, at 1-866-409-1858 or http://dhss.delaware.gov/dph/dpc/quitline.html.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phonenumber above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

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. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.

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