Health officials who have been poring over the state's cancer statistics for the past few months said yesterday they believed that tobacco and alcohol use were the major reasons why Maryland led the nation in cancer death rates.
At least 42 percent of Maryland's cancer deaths, including lung, pancreas, esophagus, bladder, pharynx, liver and larynx, are linked to either tobacco use, alcohol use or both, Dr. John Southard of the state Department of Health and Mental Hygiene said yesterday. And the Maryland death rate for all of these cancers is higher than the U.S. average, he said.
However, officials say they can't explain why Maryland's cancer death rates vary greatly from one part of the state to another. And to answer some of those questions, Gov. William Donald Schaefer said he would submit to the General Assembly a bill that would require hospitals and other institutions to report all new Maryland cancer cases to a state cancer registry.
The registry is "a high priority," said Dr. Southard, who is in charge of the Maryland Cancer Plan, expected to be completed next month. The cancer registry will receive reports of new cases and the stages at which they were diagnosed. This information, contrasted with available death statistics, will help show whether availability or quality of health care is a factor in death rates in some parts of Maryland. Registry data also can help pinpoint environmental, occupational and lifestyle causes of cancer.
Maryland's 8-year-old cancer registry has been hampered under vaguely worded law that does not require compliance of hospitals and laboratories. Some hospitals have never submitted reports.
Rick Wade, vice president of the Maryland Hospital Association, said hospitals likely would support the cancer registry bill but would watch its wording carefully. If the bill requires hospitals to submit data directly to the state registry, smaller hospitals may find it expensive to set up the system needed to comply and would likely try to pass this additional expense on to patients, he said.
Maryland's secretaries of health and environment strongly recommended the cancer reporting law when they met with Governor Schaefer last week to brief him on the state's cancer problem and offer recommendations. Mr. Schaefer ordered the briefing after learning from a report in The Sun in November that Maryland had the highest cancer death rate of any state in the nation last year.
The secretaries found that the governor wanted more work done to determine why there were major geographical differences in cancer death rates within the state, according to Robert Perciasepe, secretary of the environment. "He's called us to keep going on this," Mr. Perciasepe said. "He's not satisfied" that all the causes of Maryland's cancer problem are known.
"I think we will do some geographical studies" in cooperation with the state health department and epidemiological experts from Baltimore's major medical institutions or other epidemiologists in the Washington area, he said. For example, the governor asked his state aides to examine the high cancer rates in Baltimore and in Allegany and Somerset counties.
The health department also will begin to implement three cancer prevention programs this year. One will target tobacco use, while the other two will foster increased use of mammograms to detect breast cancer early while it is highly treatable and Pap smears to prevent cervical cancer or catch it early.
And state officials are planning to sponsor a meeting of interested health and community leaders to lay groundwork for a state plan to fight tobacco use.