Cancer death rate declining in state, report shows

Cancer screening and early detection efforts continue to drive down Delaware’s cancer death rates, say state public health officials.

In particular, officials are seeing dramatic improvements in the all-site mortality rate among non-Hispanic African-American men, which decreased by 30 percent between the five-year periods of 2001-05 and 2011-15, according to the latest cancer data.

The Division of Public Health presented its annual report to the Delaware Cancer Consortium July 8, following its meeting in Dover.

Cancer Incidence and Mortality in Delaware, 2011-2015 provides data for all cancer sites combined (all-site cancer) as well as eight site-specific cancer types - breast, colorectal, liver, lung, pancreatic, prostate, stomach and urinary bladder - for the five-year period. The report also includes information about risk factors, screening, state of diagnosis, and data trends. DPH also issued a secondary analysis report of all-site cancer incidence rates by census tract.

Delaware ranks 18th among states for highest all-site cancer mortality in 2011-15, which is a two-slot improvement compared to last year’s report, when Delaware ranked 16th highest.

According to the report, Delaware’s all-site cancer mortality rate decreased 14 percent from 2001-05 to 2011-15, the same percentage decline seen nationally. However, the state’s mortality rate of 175.1 deaths per 100,000 people was still 7 percent higher than the U.S. rate of 163.5 for 2011-15. The Delaware Cancer Consortium and the Division of Public Health remain committed to their efforts to further reduce cancer deaths in Delaware.

“We have made tremendous improvements over the years in helping Delawareans identify cancer earlier by encouraging cancer screenings, and accessing potentially life-saving treatment to improve opportunities for both short- and long-term survival,” said Gov. John Carney. “I am particularly grateful for the strong partnership between the Delaware Cancer Consortium and Division of Public Health for coordinating our state’s cancer advocacy efforts, along with the support of many stakeholders, healthcare organizations and community champions.”

This year’s report also showed notable decreases in the all-site cancer mortality rates for specific populations. From 2001-2005 to 2011-2015, in addition to the 30 percent decrease seen among African-American men, there was a 19 percent decrease among Caucasian men, and 7 percent decrease among Hispanic men. Among women, there was a 14 percent decrease for African Americans, 13 percent for Caucasian women, and 4 percent decrease for Hispanic women.

“Seeing a reduction in certain cancer disparities is both encouraging and rewarding, as it is a sign that we are making positive steps toward achieving health equity among all Delawareans regardless of race, ethnicity or gender,” said Dr. Kara Odom Walker, Department of Health and Social Services secretary.

Regarding incidence, or diagnosis of new cancer cases, Delaware’s all-site cancer incidence rate decreased 3 percent from 2001-05 (504.2 per 100,000) to 2011-15 (495.3 per 100,000). Still, the state’s all-site cancer incidence rate in 2011-15 was 13 percent higher than the comparable U.S. rate (439.2 per 100,000).

While Delaware is ranked second among states for all-site cancer incidence, this may be due, in part, to the state’s continued increases in early detection and screening. All-site cancer incidence fell 9 percent among men, but increased by 3 percent in women. Specifically, it decreased by 15 percent among African-American men, 9 percent among Hispanic men, and 7 percent among Caucasian men.

Lung cancer, the most frequently diagnosed cancer in the nation and in Delaware, accounted for 19 percent of all newly diagnosed cancer cases and 29 percent of all cancer deaths in Delaware from 2011-15. Most lung cancer cases are diagnosed in the distant stage, when the cancer has spread to distant tissues, organs or lymph nodes and is more difficult to successfully treat.

In April, the DCC launched an educational campaign to encourage current and former smokers in high-risk groups to have a low-dose computer tomography scan. High-risk individuals are those ages 55 to 80, who are current smokers and smoked a pack of cigarettes a day for the last 30 years or more, or two packs a day for the last 15 years or more; or quit smoking within the last 15 years and had those same smoking patterns. Smoking is the No. 1 risk factor for lung cancer, and 85 to 90 percent of all lung cancers are caused by tobacco use, according to the U.S. Department of Health and Human Services.

Another area of concern is the increase in liver cancer incidence and mortality. While liver cancer accounted for just 2 percent (506) of all newly diagnosed cancer cases from 2011-15, those cases represented a 75 percent increase compared to 2001-05. When comparing the two time periods, there was a 44 percent increase in deaths from liver cancer. Liver cancer incidence and mortality rates are significantly higher for African Americans than for Caucasians.

The increases are largely attributed to the hepatitis C virus, particularly in the baby boomer population, but also to three major lifestyle factors including alcohol use/abuse, smoking and obesity. While there is no vaccine for the hepatitis C virus, screening, early identification and treatment are effective.

To help Delaware residents make informed decisions about their health, DPH launched the My Healthy Community data portal earlier this year to share health data. The site delivers neighborhood-focused population health, environmental and social determinant of health data at the smallest geographical area available. To access the portal, go to www.myhealthycommunity.dhss.delaware.gov.

To view the full Cancer Incidence and Mortality Report 2011-2015, go to www.dhss.delaware.gov/dhss/dph/dpc/files/iandm2011-2015.pdf. For the secondary analysis report, go to www.dhss.delaware.gov/dhss/dph/dpc/files/ct_analysis2011-2015_2019.pdf.