Md. cedes first place in cancer list Del. now ranks first

D.C. beats both

February 10, 1993|By Jonathan Bor | Jonathan Bor,American Cancer SocietyStaff Writer

Maryland no longer bears the stigma as the state with the highest cancer death rate in the nation. But that's as good as the news gets.

The sad truth is that cancer mortality has continued its upward climb in Maryland, according to the most recent figures reported by the American Cancer Society. The difference is that cancer deaths have climbed more steeply in Delaware -- giving that state the dubious honor that has belonged to Maryland since 1990.

Here's the new picture presented by the society's bulletin, Cancer Facts & Figures 1993: The District of Columbia continued to outpace all states with a rate of 228 cancer deaths per 100,000 people. Delaware was the leading state with a rate of 195 deaths, followed by Maryland with 194 deaths.

Dr. Joseph Aisner, an oncologist at the University of Maryland Cancer Center, said the fact that Maryland and Delaware switched places means little.

What matters, he said, is that residents of this region are more likely to die of cancer than are people anywhere else in the nation.

"If you think about it, Maryland and Delaware are the same state for practical purposes," said Dr. Aisner, a member of Gov. William Donald Schaefer's cancer control commission. "It's really one region and the region is high."

The latest rates are based on reported deaths from 1985 through 1989; last year's report reflected cancer deaths between 1984 and 1989. During each five-year interval, deaths were averaged and then compared with the state's population.

Delaware took the lead by adding an average of four deaths per 100,000 people, compared with Maryland's more modest two-death increase. Washington's mortality rate rose by four deaths per 100,000 people.

Some statisticians who have looked at the numbers say the gap separating Maryland and Delaware may be too small to have any statistical significance. That's their way of saying the death rates ought to be considered as equal, given margins for error.

"There's not a statistical difference," said Norma Kanarek, a statistician with the state Department of Health and Mental Hygiene. "I wouldn't put much stock in it."

Whatever state holds the dubious title, what concerns most authorities is that cancer deaths have risen steadily in the Middle Atlantic region despite some world-class hospitals and improvements in the detection and treatment of some tumors.

But Dr. Aisner said the mounting death toll can be attributed largely to one culprit -- tobacco.

"Smoking-related cancers are not the harvest of last year," he said. "They are the harvest of 20 or 30 years ago."

He noted that the post-World War II years saw a dramatic increase in the marketing, distribution and popularity of smoking. Many of the people who were initiated into smoking in that era are the cancer patients today, he said.

Fewer people are smoking now than in the last few decades, but the drift away from tobacco is unlikely to translate into fewer deaths for many years, he said. That is because smoking-related cancers often take decades to develop.

The cancer society blames tobacco for 30 percent of all cancer deaths -- not only from lung cancer, but also from cancers of the bladder and throat.

Under the governor's cancer control plan, Marylanders are urged not to smoke. And women are urged to get regular mammograms and Pap smears -- ways of detecting breast and cervical cancers early. Moreover, men are urged to get regular prostate examinations.

CANCER DEATH RATES

Rates are based on the yearly average of deaths per 100,000 people, 1985 through 1989

HIGHEST DEATH RATES

1. District of Columbia 228

2. Delaware 195

3. Maryland 194

4. Louisiana 187

5. Maine

Kentucky

New Jersey 185

LOWEST DEATH RATES

1. Utah 121

2. Hawaii 139

3. Colorado 140

4. New Mexico 144

5. Idaho 146

NATIONAL AVERAGE

United States 172

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