The Division of Public Health presented its annual report to the Delaware Cancer Consortium on July 8, following its meeting in Dover.
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% between the five-year periods of 2001-05 and 2011-15, according to the latest cancer data.
Cancer Incidence and Mortality in Delaware, 2011-15 provides data for all cancer sites combined as well as eight site-specific cancer types — breast, colorectal, liver, lung, pancreatic, prostate, stomach and urinary bladder — for the five-year period. In addition, the report 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 the 2011-15 time period, which is two slots lower, an improvement, compared to last year’s report, in which the state ranked 16th highest during the 2010-14 time period.
Delaware’s all-site cancer mortality rate decreased 14% from 2001-05 to 2011-15, which is the same percentage decline seen nationally, according to the report. However, despite continuing decreases, the state’s mortality rate — 175.1 deaths per 100,000 people — was still 7% 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, health care organizations and community champions.”
This year’s report also showed notable decreases in the all-site cancer mortality rates for specific populations. From 2001-05 to 2011-15, in addition to the 30% decrease seen among African American men, there was a 19% decrease among Caucasian men and 7% decrease among Hispanic men. Among women, there was a 14% decrease for African Americans, 13% for Caucasian women and a 4% 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 Kara Odom Walker, Secretary of the Department of Health and Social Services and a practicing family physician. “We can achieve even greater successes as we move from a system focused on the treatment of diseases to one increasingly focused on the prevention of diseases.”
Regarding incidence, or diagnosis of new cancer cases, Delaware’s all-site cancer incidence rate decreased 3% 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% higher than the comparable U.S. rate, at 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% among men, but increased by 3% in women. More specifically, it decreased by 15% among African American men, 9% among Hispanic men and 7% among Caucasian men.
Lung cancer, the most frequently diagnosed cancer in the nation and in Delaware, continues to be of concern, as it accounted for 19% of all newly diagnosed cancer cases and 29% 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 persons 55 to 80 years of age who are a current smoker and who smoke 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 smoked a pack of cigarettes a day for 30 or more years, or two packs a day for 15 or more years. Smoking is the number one risk factor for lung cancer, and 85 to 90% of all lung cancers are caused by tobacco use, according to the U.S. Department of Health and Human Services. Recent health policy in the form of Senate Bill 25 raises the legal age for sales of tobacco and vape products in Delaware from 18 to 21. The Institute of Medicine estimates that increasing the age of sale to 21 could decrease tobacco-related deaths by 10%. The new law takes effect July 16.
Another area of concern for public health officials is the increase in liver cancer incidence and mortality. While liver cancer accounted for just 2% — 506 — of all newly diagnosed cancer cases from 2011-15, those cases represented a 75% increase compared to the 2001-05 time period. Additionally when comparing the two time periods, there was a 44% increase in deaths from liver cancer. Liver cancer incidence and mortality rates are significantly higher for African Americans than for Caucasians. Liver cancer incidence rates are 11.5 per 100,000 cases for African Americans compared to 7.6 per 100,000 cases for Caucasians, and mortality rates are 13.9 per 100,000 and 8.8 per 100,000 deaths respectively.
The increases are largely attributed to hepatitis C virus, particularly in the baby boomer population, but are also highly attributable to three major lifestyle factors including alcohol use/abuse, smoking and obesity. While there is no vaccine for hepatitis C, screening, early identification and treatment are effective.
“Liver cancer is one that can be prevented, and the power to do that is in everyone’s hands,” said DPH Director Karyl Rattay. “If we want to begin to reduce the number of new cancer cases and cancer deaths in our state, we have to ensure that injection drug users are not sharing dirty needles, increase efforts to get people to reduce their obesity risk, lower their alcohol consumption and stop smoking tobacco. DPH is planning a more in-depth look at the geographic areas where these issues intersect in order to better direct prevention-focused resources to address this issue.”
To further assist Delaware residents in making informed decisions about their health, DPH launched the My Healthy Community data portal at myhealthycommunity.dhss.delaware.gov in early 2019 to share health data in the hopes of empowering communities to address their health issues. The site delivers neighborhood-focused population health, environmental and social determinants of health data at the smallest geographical area available.
The full Cancer Incidence and Mortality Report, 2011-2015, as well as the secondary analysis report of census tracts with higher incidence of cancer, is available at https://dhss.delaware.gov/dph/dpc/cancer.html.