Reduce exposure to carcinogenic substances in the ambient environment
Coordinate with Department of Labor’s Occupational Safety & Health Office to reduce workplace carcinogenic risk and exposure
Reduce exposure to carcinogens in the indoor environment
Ensure Delawarean’s access to the highest quality cancer screening and cancer care
Ensure continuity of care through cancer care coordination
Ensure availability of accurate complete data to allow effective surveillance of cancer incidence, care delivery and treatment
Eliminate gaps in quality of life services to meet the needs of patients, survivors and co-survivors without duplicating current services
Support quality of life training and education services for healthcare providers with an emphasis on palliation, survivorship, rehabilitation and end-of-life care
Develop and implement health claims data acquisition methods
Acquire, analyze, and integrate data from electronic sources
Improve cancer surveillance methods statewide
Form and maintain a statewide, permanent alliance to coordinate and promote public education on cancer
Increased Colonoscopy CRC Screening over age 50
Increased from 52% (2002) to 74% (2008)
Highest state screening rate in the nation 2008
Since the programs inception navigators have successfully helped 4,168 through the CRC screening process
Over 3,000 CRC screenings through SFL FY02-FY09
1,475 clients had polyps removed
34 Cancers detected and treated
Distributed over 2,600 doses of the HPV vaccine to providers
Added the availability of prostate screenings as a covered screening through the Screening for Life program
Clean Indoor Air Act passed
Six-fold increase in state excise tax (24¢ to $1.60)
Youth and adult smoking prevalence decreased
Cessation efforts: Quitline & Quitnet
Community outreach: youth programs & mini-grants
Increased awareness and knowledge of tobacco issues
Menu labeling bill
Tanning bed legislation
Between 2002 and 2008, colorectal cancer screenings among African Americans increased by 53.8%
In Delaware, the colorectal cancer screening rate disparity between African Americans and Caucasians has been eliminated (BRFS 2008, AA 73.5% and White 74.7%)
The national the rates are 58.6% African American and 64.0% White
In Delaware, in 2008, African Americans were significantly more likely than Caucasians to have had a sigmoidoscopy or colonoscopy within the last 12 months (45.5% vs. 27.8%, respectively).
In 2001, only 15% of African American colorectal cancer cases were caught in the local stage; by 2007, this number had increased to 33%.
Between 2001- 2007, the proportion of local stage colorectal cancers detected for African Americans increased 113% compared to 31% for Caucasians
From 1999-2008, African American adult smoking rate declined by 43%
The decline among Caucasians for the same period was 27%
DE’s all site incidence rate for African Americans is declining more than four times faster than for Caucasians
Incidence rates for African Americans and Caucasians are similar for colorectal cancer
Racial disparities in DE’s cancer mortality rates are shrinking
Cancer Care Coordination Program served over 2,111 patients and their families
Cancer treatment validation study conducted
Delaware Cancer Registry Advisory Committee
Trained nearly 400 nurses in end-of-life care through the End-of-Life Nursing Education Consortium.
Delaware Cancer Registry Advisory Committee’s (DCRAC) active role in guiding improvements in our state’s cancer data collection.
Conducted an investigation into census tract-level rates of six environmentally-based cancers.
Analyzed data from the Indian River Community-Level Survey (IRCLS).
Reviewed available cancer-screening items included in state- and national-level surveillance efforts (e.g., BRFSS).
Evaluated cancer cluster methodologies used by the Division of Public Health.
Reviewed and refined the methodology for “ Cancer Incidence and Mortality in Delaware ” and “ Delaware’s Cancer Rates by Census Tract ” (annual DPH reports).
Initiating an investigation into statewide cancer treatment patterns using a targeted approach
Implemented education initiative per Delaware Code to inform the public and realtors of the requirement of realtors to distribute radon rights and risk information to potential home buyers
Analyzed source water for pharmaceuticals and radiological contaminants
Completed Phase I and II of the Delaware Air Toxics Assessment Study (DATAS).
Initiated a statewide quarterly quality assessment of the Columbia Aquifer to investigate potential links between drinking water supplied to individual shallow wells and cancer incidence
Increased public awareness of the dangers of eating fish from certain Delaware waterways.
Established an Occupational Health Program to identify populations at risk from occupational exposure to carcinogens
Outfitted bused in New Castle County with diesel particulate filters
Development of Phase III of the Multi-Media Body Burden study and progress being made on identifying funding to complete Phase I and Phase II of the study
Established a statewide Delaware Cancer Education Alliance
Developed the Delaware Cancer Treatment Program
Increased eligibility from 12 months to 24 months
Connected Delaware Cancer Treatment Program clients with a Cancer Care Coordinator at hospital
Prevention of Cervical Cancer by large scale adoption of HPV Vaccine
Identify screening coverage barriers for Medicare recipients
Access existing data bases (Medicaid, commercial insurance) to identify and reach unscreened individuals
Funding to claim “ Universal Cancer Screening ” for all Delawareans
Determining why mortality rates among African Americans remain higher than those of Caucasians
Achieving equal rates of participation in clinical trials between African Americans and Caucasians
Using what we have learned in cancer to eliminate other racial and ethnic health disparities in Delaware
Challenges and Opportunities
Maintain adequate funding for comprehensive tobacco programs
Sustain interest in tobacco prevention as a major health issue
Seek insurance coverage for cessation
Unify current activities into strategies for nutrition and physical activity
Increase programs for “other” lifestyle risk factors
Challenges and Opportunities - tobacco
Creating methods/tools to promote primary care cancer screening
Quality “Report Cards”: annual, facility-specific reports to inform Delawareans of performance on quality measures
Extend Cancer Care Coordination services beyond the treatment phase
Collection of complete first course of treatment data in the Delaware Cancer Registry to support studies of quality of cancer care, facilitated by electronic reporting system and insurance claims data merging, etc
Facilitating data exchange with private insurers
Capitalize on Delaware’s (relatively) small number of treatment facilities
Challenges and Opportunities - QCC
Public interest in and concern about environmental issues has created a sense of urgency to our projects
How to stay focused on current projects, while at the same time being sensitive to public concerns about new environmental challenges
The opportunity to truly help reduce cancer incident rates through the breadth of focus and depth of our resources
The ability to incorporate existing environmental monitoring into new initiatives that are bold and transformative