Declaring qualified success in combating cancer, Maryland health officials said yesterday the state has dropped from the nation's leader in cancer deaths to the fifth-worst state.
The appraisal came yesterday from the Maryland State Council on Cancer Control, which released its first five-year compilation of cancer trends. The report showed that the most important measures -- cancer death and incidence rates -- dropped incrementally from 1992 through 1996.
Death rates from the four leading cancer killers -- lung, colorectal, breast and prostate -- dropped over that period, as did rates of newly diagnosed cases. Despite this, Maryland's problem remained significantly worse than the nation's overall.
"We still have rates that are significantly higher than the United States, so we still have work to be done," said Dr. Genevieve Matanoski, an epidemiologist from the Johns Hopkins School of Public Health and a former member of the cancer control council.
Matanoski, who now oversees the collection of cancer data, and other officials presented the data at a symposium held at Martin's West.
The downturn coincides roughly with a historic turnaround nationally. Over roughly the same period, the United States saw its first reductions in cancer incidence and death rates since the 1930s. Experts say a 30-year decline in tobacco use has resulted a decrease in cancers, while early detection and better therapies have made some cancers more curable.
Maryland, which had the nation's highest cancer death rate in the late 1980s, fell behind Delaware, Louisiana, Kentucky and Maine by 1995 -- the last year for which state-by-state comparisons can be made. The District of Columbia had a higher rate than any single state.
"A decade ago, Maryland had the leading cancer [death] rate in the country," said Health Secretary Martin P. Wasserman. "This is progress."
Amid the good news was a disturbing trend: While lung cancer rates declined among men, the problem worsened among women. The trend seems to reflect evidence that smoking is coming into vogue among women, while more men are kicking the habit.
"The men have figured it out, but the women haven't quite figured out what they should be doing," said Matanoski. Lung cancer continues to strike men more frequently than women.
Six years ago, Maryland established a cancer registry which tracked disease trends in detail and started public education campaigns that urged people to give up smoking and adopt healthy lifestyles. Under Gov. William Donald Schaefer, the state also imposed a higher cigarette tax.
Among highlights of the report:
Maryland's cancer death rate declined about 1 percent annually between 1992 and 1996. By 1996, it was 179.6 deaths per 100,000 population -- still significantly higher than the estimated national rate of 169.1 deaths in 1995. (A more recent national rate was not available.)
New cancers declined 2.1 percent annually over the period. By 1996, the incidence rate was 427.5 new cases per 100,000 population -- higher than the estimated national average of 392 in 1995.
Fifty-two percent of the deaths were from cancers that are at least sometimes caused by tobacco use. These included cancers of the lung, bronchus, oral cavity, pharynx, larynx, esophagus, bladder, kidney, prostate and stomach.
Pub Date: 10/07/98