Headline: November 1990 - Maryland · 0 10 20 30 40 50 60 70 80 1975 1976 1977 1978 1979 1980 1981...

Prevention and Health Promotion Administration November 19, 2013

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Headline: November 1990 Baltimore Sun

Baltimore Sun


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Baltimore Sun


4

Baltimore Sun


5

Baltimore Sun


7

Baltimore Sun

1994


8

Baltimore Sun

1995


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NEWS

Maryland’s cancer rate improves to 5th worst. State led cancer deaths in US a decade ago

1998

Baltimore Sun


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2000 Cigarette Restitution Fund Legislation SB 896/ HB 1425


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Overall Goals of CRF Program • Decrease Cancer Mortality • Reduce Disparities among Minorities

… WHEREAS. It is the intent of the General Assembly that the State coordinate its use of the Cigarette Restitution Fund in a logical, planned, and committed fashion so as to create a lasting legacy of public health initiatives that result in a reduction of both tobacco use and morbidity and mortality rates for cancer and tobacco-related diseases in the State and otherwise benefit the health and welfare of the State’s residents… 2000 SB 896/ HB 1425


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NEWS

Maryland’s cancer rate dips below the US rate Improves to 30th highest of 50 states and DC

State led US cancer deaths twenty years ago

Headline: 2013 Baltimore

20 YEARS OF CANCER CONTROL ACCOMPLISHMENTS

The 20th Maryland State Council on Cancer Control Conference November 19, 2013 Diane M. Dwyer, MD Medical Director Center for Cancer Prevention and Control Department of Health and Mental Hygiene


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• Number of people with cancer or deaths from cancer • Rates of cancer cases and deaths • Disparities • Risk factors including rates of tobacco use • Cancer screening rates • Having health care insurance • Access to quality health care

Measuring the Burden and Accomplishments


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Measuring the Burden and Accomplishments

• Cost of research • Cost of prevention • Cost of treatment

• Total • Cost per case treated • Cost per year of life saved

• Survivorship


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NEWS

Maryland’s cancer rate dips below the US rate Improves to 30th highest of 50 states and DC

State led US cancer deaths twenty years ago

Headline: 2013 Baltimore


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Cancer Mortality


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Source: State Cancer Profiles, 1980-2010 Maryland Vital Statistics, 2011-2012


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State: Maryland Rate: 170.2 per 100,000 Rank: 30th highest out of 51

Age-adjusted Death Rate – All Cancer Sites Combined 2010, All Races, Male and Female

170.9 171.8160.6

0

50

100

150

200

250

Maryland 2010 U.S. 2010 H.P. 2020

Age-

adju

sted

rate

per

100

,000

pop

ulat

ion

Maryland and U.S. All Cancer Sites Mortality Rates, 2010Compared to Healthy People 2020 Objectives

Sources: Maryland Vital Statistics Administration from MATCH U.S. Seer, Cancer Statistics Review Healthy People 2020, U.S. Department of Health and Human Services


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Source: State Cancer Profiles

0

50

100

150

200

250

30019

7519

7619

7719

7819

7919

8019

8119

8219

8319

8419

8519

8619

8719

8819

8919

9019

9119

9219

9319

9419

9519

9619

9719

9819

9920

0020

0120

0220

0320

0420

0520

0620

0720

0820

0920

1020

1120

1220

1320

1420

1520

1620

1720

1820

1920

20

Health People 2020

Maryland

U.S.

All Cancer Site Mortality U.S. and Maryland 1975—2010 with Healthy People 2020 Goal


30 Source: State Cancer Profiles

0

10

20

30

40

50

60

70

8019

7519

7619

7719

7819

7919

8019

8119

8219

8319

8419

8519

8619

8719

8819

8919

9019

9119

9219

9319

9419

9519

9619

9719

9819

9920

0020

0120

0220

0320

0420

0520

0620

0720

0820

0920

10

Age-

adju

sted

rate

per

100

,000

pop

ulat

ion

Year of Death

Mortality Rates by Cancer TypeMaryland, 1975-2010

Lung CancerFemale BreastCervixColon & RectumMelanomaOralProstate

Ready or Not, BOOMERS

Turn

60

Ready or Not, BOOMERS

Turn

100


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U.S. Population Pyramid 1950—2050

US Census bureau data; http://www.ac.wwu.edu/~stephan/Animation/pyramid.html

85+ 80-84 75-80 70-74 65-69 60-64 55-59 50-54 45-49 40-45 35-39 30-34 25-29 20-24 15-19 10-14

5-9 0-4

U.S. Population Pyramid 1950--2050

Male Female

Year

Age

Population in Millions Population in Millions

85+ 80-84 75-80 70-74 65-69 60-64 55-59 50-54 45-49 40-45 35-39 30-34 25-29 20-24 15-19 10-14

5-9 0-4

US Census bureau data; http://www.ac.wwu.edu/~stephan/Animation/pyramid.html


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0

500

1000

1500

2000

2500

3000

3500

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

Age-

spec

ific r

ate

per 1

00,0

00 p

opul

atio

n

Age in Years

All Cancer Sites Age-Specific Mortality Rates by Gender Maryland, 2010

Male, 2010 Female, 2010 Male, 2000 Female, 2000

716 Deaths

930 Deaths

555 Deaths

776 Deaths

Source: Maryland Vital Statistics Administration from MATCH

2000 and 2010


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0

500

1000

1500

2000

2500

3000

3500

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

Age-

spec

ific r

ate

per 1

00,0

00 p

opul

atio

n

Age in Years

All Cancer Sites Age-Specific Mortality Rates by Gender Maryland, 2010

Male, 2010 Female, 2010 Male, 2000 Female, 2000

716 Deaths

930 Deaths

555 Deaths

776 Deaths

Source: Maryland Vital Statistics Administration from MATCH

2000 and 2010

67,000 people 85+

165,000 people 85+

Maryland population 85+ years*

2000

2030

Year

1,300 deaths/year from cancer in this group

3,200 deaths/year from cancer in this group

If rates of cancer stay the same….

Source: Maryland State Data Center, Maryland Department of Planning http://www.mdp.state.md.us/msdc/dw_popproj.htm


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Racial Disparities


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Source: Incidence: Maryland Cancer Registry Mortality: State Cancer Profiles


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Source: Incidence: Maryland Cancer Registry Mortality: State Cancer Profiles


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Source: State Cancer Profiles


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Cancer Risk Factors and Screening Rates


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Drive the rates DOWN Healthy lifestyles Healthy environment Screening--early detection Chemoprevention Good, early, low-cost care Research

Drive the rates UP Smoking; Other exposures Obesity Poor nutrition Lack of physical activity Lack of access to health care, etc…

Taken from Cancer Statistics 2013 Slide Presentation, American Cancer Society

1900—2009


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0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Perc

ent

Year

Percentage of Current Smokers Maryland & U.S., 1995-2010

United States Maryland


47

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Perc

ent

Year

Percentange of Current Smokers by Gender Maryalnd, 1995-2010

Male Female

MARYLAND: FIRST IN THE UNITED STATES

MMWR July 8, 2011 / Vol. 60 / No. 26

in Decreasing Colorectal Cancer Incidence Rates 2003—2007

Data source: MMWR July 8, 2011 / Vol. 60 / No. 26

Mar

ylan

d A

rizon

a A

lask

a M

assa

chus

etts

W

isco

nsin

S

outh

Car

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istri

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umbi

a Uta

h C

onne

ctic

ut

New

Ham

pshi

re

Virg

inia

W

ashi

ngto

n Fl

orid

a O

rego

n W

est V

irgin

ia

New

Jer

sey

Mai

ne

Col

orad

o N

ew Y

ork

Indi

ana

Idah

o K

ansa

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ew M

exic

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ichi

gan

Uni

ted

Sta

tes

Sou

th D

akot

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erm

ont

Ark

ansa

s Io

wa

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s H

awai

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enns

ylva

nia

Wyo

min

g G

eorg

ia

Ohi

o M

isso

uri

Ken

tuck

y M

inne

sota

Ill

inoi

s N

orth

Car

olin

a Lo

uisi

ana

Mon

tana

M

issi

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Cal

iforn

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de Is

land

D

elaw

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ahom

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ma

-7

-6

-5

-4

-3

-2

-1

0

Annu

al P

erce

nt C

hang

e Annual Percent Change in CRC Incidence by State,

2003--2007

Maryland: First in the US

Colon Exam

Adapted from Jack Tippit, Saturday Evening Post


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Summary of Cigarette Restitution Fund Colorectal Cancer Screening in Maryland

As of November 16, 2013: 25,801 People have had one or more CRC screening procedures (almost all were low income, un- or under-insured)

__________________________________________ 8,359 FOBTs (all income levels) 191 Sigmoidoscopies 24,511 Colonoscopies

DHMH, CCPC, Client Database, C-CoPD, as of 11/16/2013


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Sources: Maryland BRFSS Healthy People 2010, 2020

2020

70.5%

2011 Source: www.choosemyplate.gov, United States Department of Agriculture

Anonymous (of 215 S. Sesame Street)

P. McCartney, J. Lennon, G. Harrison, R. Star

http://www.marksdailyapple.com/rejected-food-pyramids/#axzz2lCet7MRu

http://www.choosemyplate.gov/




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Maryland Adults, 2010

• Only 27% consumed > 5 fruits & vegetables per day • Only 34% had healthy weight (not overweight or obese) • Only 32% were physically active • Only 6.6% of Maryland adults met all three healthy goals

Maryland Behavioral Risk Factor Surveillance System, 2010


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Conclusions With your help…. • Maryland has made great strides in cancer control • Maryland cancer mortality is now below the US rate • Maryland is ready to meet the challenges of:

• changing behaviors • further eliminating disparities • providing healthcare coverage and access to all

Thanks to You!


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Acknowledgements

• Kelly Richardson, MPH, Surveillance and Evaluation Unit, Center for Cancer Prevention and Control

• DHMH, Prevention and Public Health Admin. (PHPA), Cancer and Chronic Disease Bureau (CCDB), Center for Cancer Prevention and Control (CCPC)

• CCPC Surveillance and Evaluation Unit and CRF Programs Unit • University of Maryland, Baltimore—Dept. of Epidemiology and Public Health • CCPC Maryland Cancer Registry • Maryland Tumor Registrars; Westat • DHMH, PHPA, CCDB, Center for Tobacco Prevention and Control • DHMH, Office of Minority Health and Health Disparities • DHMH Minority Outreach and Technical Assistance • Maryland Local Health Departments • Maryland Academic Medical Centers: U of Maryland, Johns Hopkins • DHMH Vital Statistics • Maryland Behavioral Risk Factor Surveillance System • American Cancer Society • …..and MANY others

MDA Crop Conversion,

$4.60

Alcohol and Drug Abuse,

$21.

Education- MSDE, $5.60

OAG- Legal, $0.95

Medicaid, $71.

Tobacco, $7.70

Cancer , $24.90

BCCDTP, $14.70

Overall CRF Funding FY14: $150 Million

In millions per year

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Headline: November 1990 - Maryland · 0 10 20 30 40 50 60 70 80 1975 1976 1977 1978 1979 1980 1981...

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