Isles among lowest
in lung cancer deaths

But white women here have
the nation's top death rate
from breast cancer, a report says

Hawaii has the lowest death rate in the nation for prostate cancer among white men and the second-lowest mortality rate for lung cancer, an annual report to the nation on cancer shows.

In other good news for Hawaii, cancer incidence and mortality trends show a decline for Asians and Pacific Islanders.

The grim picture is in breast cancer: white women here have the highest rate in the nation -- 152.1 cases per 100,000 population, compared with the lowest rate of 118.7 per 100,000 in Utah.

"That's a surprising statistic, although white women always have had a pretty high rate (of breast cancer) here," said Marc Goodman, a researcher at the Cancer Research Center of Hawaii. "Now we're the highest state."

The report, published yesterday in the Journal of the National Cancer Institute, updates cancer rates and trends in the United States based on statistics and incidence rates from 1996 through 2000 on state and metropolitan registries.

The report's overarching finding is somewhat sobering: death rates for all cancers nationwide had been inching down by about 1.4 percent a year through the mid-1990s, but by 2000 that decline seems to have leveled off. At least part of that is due to a change in how cancer deaths are recorded.

"Overall, it's very good news for the nation that our cancer rates have stabilized," Goodman said.

Cancer deaths may be leveling off, but many states are lagging in proven methods to fight the most common tumors, the report concludes. It says 16 states spend less than $1 per person on tobacco control -- far less than the recommended $5 to $10 per person -- even though smoking is the leading cause of lung cancer, the nation's top cancer killer.

And there's a widening racial gap as white Americans increasingly survive certain tumors better than blacks, the report points out.

In prostate cancer, death rates for white men ranged from 36.9 per 100,000 in Maryland to 24.8 per 100,000 in Hawaii.

Hawaii had the overall second-lowest rate of lung cancer deaths at 39.7 per 100,000 population. Utah has the lowest rate, with 25.9 deaths per 100,000 population.

Hawaii men have the third-lowest lung cancer death rate in the country after Utah and New Mexico with 54.3 deaths per 100,000 population. The mortality rate for women from lung cancer is 27.4.

The Journal also reported that 20.6 percent of Hawaii's adults smoke and 12.1 percent of Hawaii's youths ages 12 to 17 smoke. Those percentages place Hawaii among the states with the fewest smokers. Utah has the lowest percentage of smokers: 13.3 percent of adults and 10.1 percent of youths.

Hawaii spends $10.82 a year per person on tobacco control programs, placing fourth in the nation in that category. Maine leads per-capital spending at $15.47.

"The numbers tell us that overall we are doing well," said Julian Lipsher, director of the state Health Department's Tobacco Prevention and Education project. "Also, what they don't reveal is there are population groups within Hawaii ... whose rates of lung cancer mortality are higher than the average."

The rise in smoking rates among 18- to 24-year-olds, despite an overall decline in other age groups, is troublesome, Lipsher said. "We will see increases in lung cancer, heart disease and other smoking-related causes in the future if these numbers don't change."

An estimated 556,500 Americans will die of cancer this year, and 1.3 million will be diagnosed with it.

The Associated Press contributed to this story.


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