Hawaii leads US for cancer survival rate
Cancer study finds living in isles is a survival boost
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People with cancer in Hawaii are more likely to survive the disease than people who live in other states and even some countries, according to an international study.
Where you live makes a difference when it comes to cancer survival, the study found.
It's not clear why Hawaii stands out for cancer survival, researchers said, suggesting it could be because of better access to health care or a healthier lifestyle and less stress.
Jackie Young, a cancer survivor and Hawaii American Cancer Society, Hawaii Pacific Division, Inc., officer, said the report "is certainly good news, even more reason for living in Hawaii."
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Hawaii not only has enviable weather but it has the best survival rate for cancer in the United States, as well as in many other countries, an international study reveals.
The CONCORD study compared cancer survival in 16 states and metropolitan areas of the United States and from within 31 countries on five continents.
» In the U.S., New York City had the lowest survival rates for all cancers studied except rectal cancer in women.
» Cancer survivor rates favor whites in a comparison with black populations in the U.S. Variations range from 7 percent for prostate cancer to 14 percent for breast cancer. The most likely reasons for the disparities are the stage of cancer at diagnosis, access to health care and compliance with treatment, researchers said.
» Significant differences were found in cancer survival rates between the United States and Europe. U.S. survival rates were 10 percent higher for breast cancer and 34 percent higher for prostate cancer.
» Australia and Canada have high survival rates for most cancers. Algeria has the lowest survival for all cancers in men and women.
» Sweden has the highest survival rate in Europe for breast cancer and Austria has the highest survival rate for prostate cancer.
» Poland and Slovakia are the worst performing European countries.
Data on cancer survival was compared within regions of 31 countries and 16 states and metropolitan areas in the United States in the CONCORD study, published in the July 17 online edition of The Lancet Oncology.
"The good news for us is Hawaii is the best performing in all areas studied except rectal cancer in men (Idaho was better) and prostate (Seattle was better)," said Marc Goodman, head of the Hawaii Tumor Registry in the Cancer Research Center of Hawaii.
He said he did a spot check of all the statistics and "on the ones I checked, we had the highest survival overall. People in Hawaii are doing fairly well."
Why this is so isn't clear, Goodman said. Physicians may attribute the high survival rates to good medical care, "which could well be," he said. "It must have something to do with living in Hawaii," he added, suggesting diet, exercise and fewer stresses as possible factors.
It couldn't be ethnic differences because the study compared white women in Hawaii to white women everywhere, he said. Incidence rates for white women with breast cancer in Hawaii were the highest in the United States "but they don't necessarily die from it," he said.
Whatever the reason for Hawaii's high cancer survivorship, he said, "It's just real nice."
More than 100 scientists, including Goodman, participated in the study, led by Michael Coleman, an epidemiology professor at the London School of Hygiene and Tropical Medicine in Great Britain.
They collected data on nearly two million cancer patients from registries in every country and compared five-year survival rates for breast, colon, rectum and prostate cancers. Patients were diagnosed from 1990 to 1994 and followed to the end of 1999.
Cancer survivor rates appear linked to the country or state where a person lives and whether a patient is black or white. U.S. survival rates favor whites.
Coleman, in an online HealthDay report, said he believes differences among countries and within regions are related directly to access to health care. "This is not a question of the competence of doctors in any particular country," he said. "This is an issue of the overall effectiveness of health services."
The U.S. had the highest survival rates for breast and prostate cancers; Japan has the highest rates for colon and rectal cancers among men, and France has the highest rates for female colon and rectal cancer, the study found.
Jackie Young, a cancer survivor and Hawaii American Cancer Society, Hawaii Pacific Division, Inc., officer, said the state's high survival rates are reflected in the organization's Relay for Life events.
"We're seeing more survivors willing to come out to show they're surviving. Now we're looking at disparities among native Hawaiians, Filipinos, Hispanics and Latinos. We're working to decrease mortality rates in those groups," Young said.
The cancer society last year got 35 state representatives and 15 senators to sign a "Cancer Promise," a commitment to support legislation to fight cancer, she said. The Legislature also appropriated $150,000 for a breast and cervical cancer screening program for the uninsured and underinsured, she said.
Darlena Chadwick, vice president for patient care at the Queen's Medical Center, which has 48 percent of Hawaii's adult oncology cases, believes advances in screening to detect cancers earlier and new technology for treatment are contributing to Hawaii's high survival rates.
She pointed to the Queen's Medical Center's two "da Vinci" robots used for prostate cancer. "Clinically, we're doing a really good job," she said.
Queen's cancer center last year had more than 2,300 cancer cases, with breast cancer comprising the highest volume followed by prostate, she said.
The American Cancer Society estimates Hawaii this year will have 6,310 new cancer cases, she said.
Hawaii has the lowest death rate in the nation for women for all cancers, according to the cancer society, Chadwick said. Hawaii's cancer death rate is 10 percent below the national rate for men and 26 percent below the national rate for women, she said.