Thirteen years ago, Delaware ranked No. 2 on the nation's list of the highest cancer death rates by population. Today, Delaware ranks No. 14.
State officials, who released the latest cancer data April 30 near Rehoboth Beach, cited emphasis on cancer screenings as the reason for the reduction in cancer deaths.
"I think the success of the Delaware Cancer Consortium has been due to incredible leadership from the top," said Delaware's Congressman John Carney said. "The physician leadership that we have on our committee has brought just tremendous work to keep our efforts science-based, research-based and data-driven."
Carney, a member of the Delaware Cancer Consortium advisory board, said he hopes the state will get to No. 20 on the national cancer death rates list in the next few years.
The five-year report looks at cancer statistics for the state using census tracts – where people file their census data – to understand incidences of cancer and mortality rates.
"We analyzed 25,068 cancer cases for this report," said Dr. Karyl Rattay, director of the Division of Public Health.
Nine census tracts had significantly higher cancer rates than the state as a whole; 16 had a incidence rate lower than the state average, Rattay said. The remaining fell in line with the state average.
Over the same period, national cancer incidence decreased 3.9 percent - 6.1 percent among males and 3.3 percent among females.
In Delaware, the cancer incidence among women decreased by 2 percent; among men incidence decreased by less than 1 percent.
"It's complex to say why Delaware has decreased more slowly, but part of it is increased screenings," Rattay said. As more people are screened for numerous cancers, then cancer cases are caught more quickly, which can also increase the number of cancer cases in the state.
"We have a long way to go. We have a great deal of room for improvement,” Rattay said.
Screenings improve survival
Dr. James Spellman, surgical oncologist at Beebe said increased cancer cases has not meant more deaths in Delaware.
"Some of the increases may look alarming, but to me it means that we are doing a very aggressive job of trying to tackle this problem up front,” Spellman said.
Free screenings for Delaware residents who do not have insurance or insurance that does not cover preventative screenings have been provided through Screening for Life, which offers office visits, mammograms, cervical cancer screenings, prostate cancer screenings, colorectal cancer screenings and health education.
In 2012, the program screened more than 4,000 women for breast cancer; 3,400 women for cervical cancer and 400 people for colorectal cancer.
Colorectal cancer screening has improved more than any other type of screening. Statewide, over the past five years, colorectal cancer cases declined by more than 22 percent. The improvement was greatest among African American women, Rattay said, with the mortality rate declining by 30 percent.
In addition, Delaware rates for cervical, esophagial, larynx, ovarian and stomach cancer are declining faster than U.S. rates.
"Lives are being saved; we are seeing significant improvement in our cancer death rates. Our rated of decline is 50 percent higher than the national decline," Rattay said.
To enroll in Screening for Life, call 211 or 302-744-1040.
Lung cancer – not much progress
Lung cancer, breast and prostate cancer rates are increasing faster than the national average.
Rattay said about 15 percent of cancer in Delaware is lung cancer, but 30 percent of all deaths are from lung cancer.
Delaware women ranked fourth highest in the nation for lung cancer mortality. Delaware men improved over the past five years; lung cancer rates decreased by more than 27 percent. Delaware men rank 19th in the nation for lung cancer mortality.
More than 85 percent of all lung cancers are caused by smoking tobacco products, Rattay said.
“Only minimal progress has been made,” Rattay said. "Prevention is essential."
Rattay said lung cancer is often caught too late because there are not always symptoms. She said smoking cessation programs exist, and state officials plan to increase awareness and education campaigns this year to reach more people.
“The key is to get to them before they start smoking,” Carney said.
Spellman said the consortium aims to increase programs to prevent tobacco use as well.
"Cigarettes and tobacco products of any sort continue to be a problem not only in this state but across the country in terms of health risk," Spellman said.
"The Delaware Cancer Consortium recognizing this is renewing efforts to make sure that our legislative comrades understand us and continue to support the efforts to reduce the availability and the use of all tobacco products at any age and in any form to our population in Delaware," he said.
In Delaware, 127 out of 100,000 women have breast cancer, which is slightly higher than the U.S. average of 124 out of 100,000. In addition, breast cancer mortality in Caucasian women in Delaware has decreased by 9 percent.
"Our screening efforts are really paying off," Rattay said. "We are identifying these cancers earlier, getting people into treatment, saving lives and saving dollars."
Delaware Cancer Consortium will use the statistics from this report to determine the underlying reasons for increased incidence, and find areas of improvement for performance, which could lead to legislation, Spellman said.
Consortium officials are going to hospitals and looking at registry data to see how many breast cancer screening patients are falling outside the recommended 60 days from first contact to first treatment, he said.
"We want to set standards for every hospital in Delaware," Spellman said.
"A good portion of all cancer incidences and mortality in Delaware is preventable if we can get people to quit smoking or not start in the first place, and get people to live a healthier lifestyle," Carney said.
The full cancer report is available online at www.dhss.delaware.gov/dhss/dph/dpc/cancer.html. To arrange a presentation for a group or organization, call 302-744-1040.
Millsboro man talks about pancreatic cancer diagnoses
Born in the Bronx, Raymond Kalmanowitz retired to Millsboro with his wife Fifi and their son.
During a regular doctor's appointment more than three years ago, Kalmanowitz's life changed.
"I was informed I was turning jaundiced," he said. "I was sent to Beebe and an MRI was taken."
At Beebe, Kalmanowitz was diagnosed with pancreatic cancer, one of the most deadly forms of cancer. He was referred to an area specialist and began chemotherapy treatments.
His first question was, “how long do I have to live," Kalmanowitz said. "When I returned home, I kneeled down and prayed to the Lord."
Kalmanowitz, 66, said he wanted to live longer to spend more time with his son, who is now 9. After nearly a year of regular chemotherapy, Kalmanowitz received good news – no more treatment, he said.
For 13 months, he lived freely with fewer medical appointments. He only had to have a scan every three months.
He was able to enjoy his family. This May, he will return for chemotherapy treatment because a nodule has started to grow again.
In Delaware 12.6 percent of people have pancreatic cancer, which is just slightly higher than the U.S. average, but the number of cases in Delaware has increased by more than 18 percent since 1999 while the U.S. average has only increased by 7 percent.
For Kalmanowitz, the cancer was caught early and he has been healthy for the past two years.
"There is no cure; pancreatic cancer is the fourth deadliest cancer I believe," he said. "My cousin had this and he lasted a month, so I've been doing alright for three-and-a-half years."