New Maryland Plan Targets Cancer Deaths

Maryland in 1992, according to the society.

Within Maryland, the highest cancer death rates are found in DTC Baltimore and in Somerset, Charles and Anne Arundel counties.

"Maryland is high in a few of the very prevalent cancers, so all of those combined bring us to be No. 1," said Norma Kanarek, planning director for the Local and Family Health Administration in the state Department of Health and Mental Hygiene.

In lung cancer, the leading cause of cancer deaths, Maryland ranked fifth among the 50 states from 1983 to 1987. The state ranked seventh in breast and colon and rectal cancers, 10th in pancreatic cancer and fifth in prostate cancer during the same period, the most recent for which state breakdowns are available.

Maryland's high cancer mortality has been known for decades, health experts say, but it began to receive increased public and media scrutiny two years ago when the state moved into first place.

Just why cancer death rates are so high in Maryland has not been established. Among the potential explanations that experts have ventured in recent years:

* Relatively high rates of smoking and drinking among some groups of Marylanders.

* Diets high in fats, smoked and salt-cured food, particularly in rural areas.

* Poverty, low levels of education and a resulting lack of access to information about basic health care, to quality medical services and to preventive and early-detection programs.

* Exposure to industrial pollutants, and to pesticides and herbicides used heavily in some Maryland farm fields.

"We like to look to external issues to blame," said Dr. Joseph Aisner, director of the University of Maryland Hospital Cancer Center. "It's nice to blame the gas station on the corner because they smell bad. But in point of fact . . . most of it has to do with what we do to ourselves."

The presence of two major cancer centers -- University of Maryland and Johns Hopkins hospitals -- isn't a factor because the statistics are based on cancer patients' place of residence, not where they die, Dr. Aisner said.

The high rates in neighboring Washington and Delaware suggest that whatever is responsible is regional. "And that fits," he said, "because whether you want to explain it by environment or personal habits, those tend to be regional rather than follow state boundaries."

Virginia has the 10th highest death rate among the states, and Pennsylvania ranks 12th, according to the society.

The society said about 30 percent of all cancers in the United States are directly related to the use of tobacco. Another 35 percent are linked to diet.

In an effort to find ways to attack Maryland's high cancer death rates, health agencies in the state formed the Maryland Cancer Consortium in 1989 and launched an 18-month study to analyze statewide patterns.

"I am very concerned that Maryland ranks No. 1 for cancer," Gov. Schaefer said at a news conference yesterday. "I just can't tell you how hard we are going to push for that [cigarette] tax. It will save lives," he said.

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