The latest report from the Delaware Division of Public Health shows the First State's cancer incidence and mortality rates are dropping.
They’ve been steadily declining since the 1990s, when Delaware ranked second in the nation for overall cancer mortality.
Delaware currently ranks 15th in the nation for highest overall cancer mortality, and 20th for highest overall cancer incidence.
“For our overall incidence rates, we do have a higher incidence of cancer. So the specific number is 457.6 per 100,000. The US rate is 442.2 per 100,000 population,” said DPH Chronic Disease Epidemiologist Sumitha Nagarajan.
While mortality rates in Delaware are also slightly higher than the US rates, they’re dropping more rapidly than incidence rates on both a state and national level.
Between 2006 and 2020, state mortality rates decreased an average of 1.8% per year, 0.1% faster than U.S. rates (1.7%).
Incidence rates continue to lag behind, decreasing an average of 1.1% per year on a state level. That’s still 0.5% faster than the national level, which is an average decrease of 0.6% per year.
DPH’s Bureau Chief of Cancer Prevention and Control Program Dawn Hollinger says the state is focused on early screening and prevention, which are vital to reducing both mortality and incidence rates.
“We’ve increased our outreach and education efforts for our priority populations to try and enroll more individuals into our Screening for Life program,” explained Hollinger. “What that program does is it offers free cancer screenings for breast, cervical, colorectal, lung, and prostate cancers to our uninsured and underinsured residents of Delaware. Those who are most vulnerable and have the most increased burden for cancer.”
The Screening For Life Program also offers assistance with covering cancer treatment costs if someone is diagnosed with cancer. Uninsured and underinsured Delaware residents who meet certain guidelines are eligible for that financial assistance.
Hollinger says DPH is committed to increasing access to routine care and screenings. That’s why they’re bringing it directly to the community.
“We're conducting outreach at community-based organizations, and we are attending health fairs embedded in the community, and not just larger events,” said Hollinger. “We're also very reliant on our health promotion advocates who are embedded in our federally qualified health centers. They promote this cancer screening program and they enroll eligible Delaware residents. They also help navigate those clients to their cancer screenings and connect them to a health home.”
Nagarajan emphasizes the importance of timing cancer screenings correctly. Age, gender, genetics, and day-to-day activities can greatly affect one's risk.
“We want to make sure that everyone has timely access to screenings, and understand the timelines of these screenings,” said Nagarajan. “For mammograms they’re every year, for prostate cancer, depending on if you have a first degree relative who had prostate cancer you might have to get screenings every three to five years.”
The top four cancers for both incidence and mortality are female breast, prostate, lung and bronchus, and colorectal.
And Black Delawareans continue to be disproportionately affected by breast, prostate and colorectal cancers compared to other groups.
Between 2005 and 2019, mortality rates for all-site cancer decreased an average of 2.1% per year among Black males, but remained stable for Black females.
Black women in Delaware continue to have a higher mortality rate for breast cancer at 15.5 cases per 100,000 population compared White women (11.2 cases per 100,000 population).
In 2015, the National Cancer Institute reported that Delaware had the highest incidence of triple negative breast cancer, the most aggressive form of breast cancer, among the state’s Black population.
That statistic continues to inform treatment and prevention strategies in the state’s medical community.
ChristianaCare recently launched two initiatives to tackle disparities in breast and lung cancer.
And DPH uses that data, and what is outlined in their annual reports, to target populations in most need of preventative care and treatment.
“We know that non-Hispanic Black females have a greater risk of breast cancer, including triple negative breast cancer. So we do want to direct education and outreach to those women to make sure that they understand that early screening is their best weapon in decreasing any risk, and especially mortality risk,” explained Hollinger.
The Healthy Delaware website is one of the tools created by Delaware Health and Social Services to help Delawareans learn how to prevent, detect, and treat chronic diseases like cancer.
That can be found at HealthyDelaware.org.
