Mixed Results in Del. Cancer Mortality Study

October 12, 2021/The Talk of Delmarva News

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Delaware is making some progress in reducing cancer mortality, but the state holds the 15th-highest rating for cancer mortality in the time frame of 2013-2017, unchanged from 2012-2016.

The Division of Public Health presented its data report to the Delaware Cancer Consortium Monday. To read the report, please CLICK HERE

Findings are mixed, but Health and Social Services Secretary Molly Magarik said the study clearly shows that early screening and prevention are critical for reducing cancer mortality rates. She also said the COVID-19 pandemic has led many people to hold off cancer screenings and to delay other preventive care for chronic diseases.

“After decades of dedicated early detection and screening efforts by a wide array of partners, it’s reassuring to see improvement in certain areas,” Governor John Carney said. “I commend the Delaware Cancer Consortium and the Division of Public Health for expertly coordinating our state’s cancer prevention advocacy and education. I also thank those Delawareans who get their recommended cancer screenings, and encourage everyone to do the same.”

“The data show us clearly that early screening and prevention are critical for bringing down cancer mortality rates. Unfortunately, the COVID-19 pandemic has caused many people to delay cancer screenings and other preventive chronic disease care, and economically disadvantaged communities are typically impacted the most,” Magarik added. “Free cancer screenings are available to eligible Delawareans and we know they can lead to earlier diagnosis and to saving lives.”

“In order to address the disparities that persist in cancer incidence and mortality, we must address the circumstances in which people are born, grow up, live, work, and age and the systems put in place to deal with illness,” DPH Director Dr. Karyl Rattay said. “These social determinants of health include housing and neighborhood conditions, educational and economic factors, transportation systems, social connections, and other social factors. We must look at the racial disparities across the cancer continuum from prevention to end-of-life care that result from differences in the social determinants of health as no longer endurable.”

Other key findings were provided below by Delaware Health and Social Services:

For 2013-2017, the state’s all-site cancer mortality rate (171.0 deaths per 100,000 people) was higher than the U.S. rate (158.3 deaths per 100,000). Also, for 2013-2017:

  • Delaware males (204.1 per 100,000) ranked 17th for all-site cancer mortality (18th in 2012-2016) and had higher rates compared to U.S. males (189.5 per 100,000). 
  • Delaware females (146.3.1 per 100,000) had a higher all-site cancer mortality rate compared to U.S. females (135.7 per 100,000) and ranked 17th for all-site cancer mortality, an improvement from 14th in 2012-2016.   

Regarding incidence or diagnosis of new cancer cases, in 2013-2017, there were nearly 29,000 new cancer cases diagnosed in Delaware, a slight increase from the 28,581 cases in 2012-2016 . Of those cases, 51% of those diagnosed were male, and 78% were non-Hispanic Caucasians. Delaware saw statistically higher rates (484.3 per 100,000) for all-site cancer incidence than the U.S. (435.0 per 100,000). Also, for 2013-2017:

  • Delaware males (531.5 per 100,000) had a higher all-site cancer incidence rate compared to U.S. males (472.9 per 100,000), ranking fourth nationally, an improvement from third in 2012-2016.
  • Delaware females (450.8 per 100,000) had a higher rate of all-site cancer incidence in 2013-2017 compared to U.S. females (410.5 per 100,000); their ranking improved to ninth from fifth in 2012-2016. 

BREAST CANCER

Breast cancer is the most common type of cancer among women in Delaware. In 2013-2017:

  • From 2003-2007 to 2013-2017, female breast cancer mortality in Delaware decreased 2%, compared to the U.S. decline of 15%.
  • Female breast cancer incidence rate for Delaware (135.4 per 100,000) was higher than the U.S. female rate (126.8 per 100,000). 
  • Delaware’s percent of female breast cancer cases diagnosed at the local stage increased from 42% in 1980-1984 to 68% in 2013-2017. 
  • Delaware females 40 years of age and older who reported having a mammogram within the previous two years ranked third-highest nationally (79%) in the 2018 Behavioral Risk Factor Survey.

COLORECTAL CANCER

Colorectal cancer is the fourth most diagnosed cancer in the U.S. and Delaware. Delaware ranked 11th-highest in prevalence in the U.S. for meeting the U.S. Preventive Services Task Force colorectal screening recommendations. In addition:

  • Between 2003-2007 and 2013-2017, incidence rates for colorectal cancer decreased by 26% in Delaware and 21% in the U.S.
  • During the same 10-year time period, mortality rates for colorectal cancer decreased by 21% both in Delaware and in the U.S.
  • Nearly 73% of Delawareans age 50-74 years reported meeting the recommendations, more than the national median of 70%. 
  • For 2013-2017 in Delaware, non-Hispanic African Americans (44.6 per 100,000) had a statistically higher colorectal cancer incidence rate compared to non-Hispanic Caucasians (37.6 per 100,000).
  • Non-Hispanic Caucasians accounted for 78% of colorectal cancer deaths in Delaware in 2013-2017.

LUNG CANCER

Lung cancer remains the most frequently diagnosed cancer and the most common cause of cancer deaths in the U.S. and Delaware. In addition:

  • Delaware males (75.7 per 100,000) had a higher lung cancer incidence rate compared to Delaware females (61.3 per 100,000). 
  • Delaware’s 2013-2017 lung cancer incidence rate improved to 17th, compared to 10th in 2012-2016. 
  • Delaware’s 2013-2017 lung cancer mortality rank improved to 16th from 14th in 2012-2016.
  • Non-Hispanic Caucasians accounted for 82% of lung cancer cases in 2013-2017. 
  • Hispanics (29.1 per 100,000) had a lower lung cancer incidence rate compared to both non-Hispanic Caucasians (70.7 per 100,000) and non-Hispanic African Americans (65.5 per 100,000). 
  • Over the past decade, cancer incidence rates decreased among all sex, race, and ethnic groups. From 2003-2007 to 2013-2017 in Delaware, lung cancer incidence rates decreased:

·       21% in non-Hispanic Caucasian males

·       11% in non-Hispanic Caucasian females

·       31% in non-Hispanic African-American males

·       13% in non-Hispanic African-American females

·       45% in Hispanic males

·       55% in Hispanic females

PROSTATE CANCER

Prostate cancer is the most diagnosed cancer among males in the U.S. and Delaware. According to the 2020 Behavioral Risk Factor Survey (BRFS), 33% of Delaware males 40 and older reported having a Prostate Specific Antigen (PSA) test in the past two years, compared to the national median prevalence of 32%. In addition:

  • Between 2003-2007 and 2013-2017, prostate cancer incidence rates decreased by 30% in Delaware and 33% in the U.S.
  • Between 2003-2007 and 2013-2017, mortality rates for prostate cancer decreased by 31% in Delaware and 24% in the U.S.
  • In 2013-2017, Delaware’s non-Hispanic African Americans (205.8 per 100,000) had a much higher prostate cancer incidence rate compared to non-Hispanic Caucasians (110.3 per 100,000) and Hispanics (114.3 per 100,000). 
  • Non-Hispanic African Americans (34.1 per 100,000) in Delaware had a higher prostate cancer mortality rate in 2013-2017 compared to Delaware’s non-Hispanic Caucasians (14.2 per 100,000). 

CERVICAL CANCER

Cervical cancer accounted for 1% of all female cancer cases in Delaware in 2013-2017. According to the BRFS, 83% of Delaware women 21-65 years of age reported that they had had a Pap test within the previous three years, compared to the national median of 80% among U.S. women of the same ages. In addition:

  • Delaware ranked 20th in the U.S. for cervical cancer incidence, a six-place improvement from 14th in 2012-2016.
  • Non-Hispanic Caucasians accounted for 70% of Delaware’s cervical cancer cases in 2013-2017.
  • Non-Hispanic Caucasian females (48%) had a higher proportion of cervical cancer diagnosed at the local stage compared to non-Hispanic African American females (35%).
  • In 2013-2017, Delaware’s cervical cancer mortality rate (2.6 per 100,000) was not statistically significantly different from the U.S. cervical cancer mortality rate (2.3 per 100,000).

 RESOURCES

  • The Screening for Life (SFL) program provides payment for cancer screening tests to qualified Delaware adults. Eligible individuals can receive office visits, mammograms and clinical breast exams, Pap tests and screening tests for prostate, colorectal, and lung cancer when recommended by a doctor. SFL also provides lung cancer screenings for eligible men and women. Contact SFL at https://www.dhss.delaware.gov/dph/dpc/sfl.html or call 302-401-4212 to speak with a screening nurse navigator.
  • Delaware residents 18 and older who want help quitting smoking should contact the Delaware Quitline at 1-866-409-1858 or QuitSupport.com. 
  • For population health, environmental and social determinant of health data at the smallest geographical area available, visit the My Healthy Community data portal at de.gov/healthycommunity. 
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