ASPO Abstracts
Two and a Half Decades of State-Specific Cancer Mortality Progress
Category: Cancer Health Disparities
Conference Year: 2019
Abstract Body:
Our purpose was to examine how Maryland’s (MD) cancer mortality went from second worse (241.7 deaths/100,000) among the states and the District of Columbia in 1990 to 34th (155.3 deaths/100,000) in 2015.Methods: Compressed mortality, age-adjusted rates were obtained from Wonder.cdc.gov or cancercontrolplanet.gov for overall and white and black race; rate differences, percent change in rates, and rate trends were calculated. We selected 1990 as the start date for this analysis because the peak of MD cancer mortality was observed in 1990 and was the year the state produced its first cancer plan. 1990, statewide, was also the first time new since cervical cancer initiatives of the ‘70s and ‘80s governmental investments in cancer prevention and control were made. Behavior prevalences were obtained from CDC’s Behavioral Risk Factor Survey for the state and nation.Results: Cancer among all sites has declined steadily by 1.4% between 1990 and 2000 and by 1.9% since 2000 in MD. Relative decline in cancer mortality overall and among MD’s Cancer Plan’s seven targeted cancers (lung, prostate, breast, colorectal, cervix, head and neck cancer and melanoma) was 1.8 times (declines of 47% compared to 26%) that of the US from 1990 to 2015. At the same time, all remaining cancer sites that were not targeted in MD outpaced the US (22% versus 12% decline). Relative changes in black-white differences were similar at 69-70% respectively, while the decline in absolute differences between whites and blacks were larger in MD (60.2 deaths/100,000) compared to the US (47.3 deaths/100,000). All cancer plans since 1990 have targeted smoking avoidance and cessation, mammography, and Pap smears, which in most recent statistics exceed prevalences found in the US.Conclusions: Targeting specific cancers in MD led to almost a two -fold decline compared to the US. Also targeted in the state’s cancer plan were racial disparities. In a state with proportionately more blacks, it is ultimately very important to reduce disparities as well.
Keywords: cancer mortality, disparities, Maryland