The next time the Red Sox are on TV from Boston, think about this: Half of the men and a third of the women packed into Fenway Park to watch the game will receive a diagnosis of cancer during their lifetimes.
The bleak reality is that half of those who do will die from cancer, according to Nobel laureate Harold Varmus, former director of the National Institutes of Health.
Cancer statistics are even more grim for Mainers, according to data amassed by federal and state cancer registries and analyzed by the Maine Cancer Consortium. Cancer has a larger relative burden on Maine when compared with most of the nation.
The Maine Cancer Registry shows that each year more than 8,000 Maine residents are diagnosed with one of the more than 100 types of cancer. About 3,100 Mainers die of cancer-related complications every year, accounting for nearly a quarter of all deaths in the state. Four types of cancer — lung, breast, prostate and colon — account for half of all cancers diagnosed in Maine.
In 2005, Maine’s age-adjusted cancer incidence rate was the second-highest in the nation with 518 out of every 100,000 residents diagnosed with the disease, compared with 456 out of 100,000 nationally. During that same year, Maine’s death rate due to cancer was 205 per 100,000 residents, topping the national rate of 184 per 100,000.
By 2009, the incidence of cancer dropped in Maine to 481 residents out of 100,000, but still remained higher than the national rate of 465 cancer diagnoses for every 100,000 Americans.
One reason for that statistical disparity may be that Maine is America’s oldest state, with the highest median age at 42.7 years.
“Age is a possible explanation for the high cancer rate,” said Dr. Molly Schwenn, director of the Maine Cancer Registry. “Aging does add to the burden of cancer in a community, county or state, since an individual’s risk for cancer increases with age.”
Cancer rates vary widely among Maine’s 16 counties, as do types of cancer. Lung cancer is a particular problem throughout Maine and especially in Washington County, which has the most elderly population among Maine counties, according to public health data. Statewide, 2008 death statistics and 2009 diagnosis statistics show a statewide lung cancer rate of 79 per 100,000 residents, compared with a national rate of 59. In Washington County, the 2007-09 rate for lung cancer diagnosis was 99, the highest among Maine’s counties.
Why is lung cancer so prevalent in Washington County?
“A major factor to explain the high rate of lung and some other cancers in Washington and other Maine counties is tobacco use,” Schwenn wrote in an email. “The adult smoking rate reported in the 2012 Maine State Health Assessment for Washington County is 23 percent, compared with 18 percent for Maine as a whole.
“Obesity is also elevated in Washington County at 36 percent [of the population], compared with 28 percent for Maine,” she said. “Sedentary lifestyle, which may play a role in the risk for some cancers, is likewise elevated in Washington County, 32 percent versus 23 percent for Maine. Given these three risk factors, it is not surprising that in Washington County not just cancer but other chronic diseases occur in higher percentages of the population and/or have higher death rates, for example chronic obstructive pulmonary disease and diabetes.”
Another potential influence on the cancer incidence and mortality rates in Washington and other Maine counties is low cancer screening rates, especially for colon cancer, Schwenn said. Also contributing, she said, are lower levels of education, high rates of poverty and unemployment, and lack of health insurance.
“All of these measures of socioeconomic status are high, or low, when Washington County is compared to Maine,” she said. “Access to medical facilities and to primary care, including distance [required] to travel for care, may also affect cancer rates.”
While cancer statistics for 2012 aren’t yet available, the American Cancer Society estimated that Maine would record an estimated 9,000 new cases of cancer last year, including 1,340 new cases of lung cancer and 1,170 new cases of breast cancer.