On The Map Information on Delaware's Cancer Rates by Census Tract. (Page 2) About These Rates Senate Bill 235 requires the state Department of Health and Social Services to make available, as public records, cancer incidence by census tract. Cancer incidence tells us how many times doctors identifed someone with cancer. The numbers used for each color on the map below are rates that tell us how many people out of 100,000 had cancer there from 2001-2005. Lines on the map show areas called census tracts, which were created by the U.S. Census Bureau to look at population changes. Delaware’s 197 census tracts are often different from townlines and districts. Census tractsin cities are often smaller than tracts in rural areas. This is because in the city, similar numbers of people live closer together. The age of the population does not play a role in the rates shown on the map. By using a mathematical process called age-adjustment, incidence rates are not affected by age differences between census tracts. This means that we can compare incidence rates for different census tracts, even if one census tract has a much older population. Cancer rates may be as expected in one area and surprise you in another area. The map does not tell us why cancer rates in areas are similar or different. The color-coded rates do not tell us: - Whether or not people with cancer moved to the area or always lived there. - Whether or not people living there see a doctor more or less often than other people. - Whether the kind of cancer people have in one area is the same or different as other areas. - Whether or not people with cancer in an area got better or not. - Whether or not people in the area smoke more, eat less fat, or have more chemicals in their home. HIGHER RATES Most of the time, studies to find out why some areas have high cancer rates do not find answers. Studies which do find the causes of high cancer rates usually involve: - An area with cases of mostly one type of cancer. - An area with cases of a rare type of cancer. - An area with cases of a type of cancer not usually found in that age group. Legend The U.S. cancer incidence rate for 2001-2005 was 467.4 per 100,000. Counties Fewer than 25 cases Incidence Rates 0.0 -447.3 447.4 -499.0 499.1 -560.7 560.8 -614.4 614.5 -991.2 Map created by Delaware Health Statistics Center For more detailed maps and information, go to: http://www.dhss.delaware.gov/dhss/dph/dpc/cancer.html (Page 3) What You Should Know How are suspected cancer clusters identified? Delaware’s Division of Public Health (DPH) starts by gathering information about the cluster, such as types of cancer, number of cases, and the sex, ethnicity, address, and age at diagnosis of those with cancer. This information is compared to the whole state to see if there is an unusual pattern. Areas reported as cancer clusters often do not have enough cases for public health staff to know if they are clusters. Often the reason why a cluster exists can not be found at all. How do I find out about cancer clusters studied in Delaware? Contact DPH’s cancer program at 302 -744 -1020 or go to www.dhss.delaware.gov/dph/dpc/cancer.html Is something in the area’s environment causing cancer? It can be hard to tell if a person’s environment caused their cancer. Cancer is caused by so many different things that it is usually difficult if not impossible to know what the cause was. Pollution, viruses, medicines, diet, tobacco, sunlight, alcohol, our genes and our hormones all play a role. We have contact with some or all of these every day over many years. It is hard to know all of the cancer causing things we are exposed to over a lifetime and which one, if any, was the cause. How can I get cancer services? Cancer screening and treatment is available through your health care provider or the Division of Public Health program listed on the back page. Call DPH’s cancer program at 302-744-1020 or go to: www.dhss.delaware.gov/dph/dpc/cancer.html What can I do about cancer? The following are general guidelines. You should ask your doctor about what is best for you . - See your doctor or clinic for a yearly check up. Make sure to mention if anyone in your family has cancer. - Girls and young women 9 - 26 years old can receive a shot to prevent cervical cancer, called the HPV vaccine. - Men age 50 and older should be tested for prostate cancer. Men with a family history of prostate cancer should be checked starting at a younger age. Ask your doctor. - Women should receive yearly Pap tests. - If you are a woman over age 40 or at increased risk for breast cancer, get a mammogram. - If you are over age 50 or at increased risk for colorectal cancer, get a colonoscopy at intervals recommended by your health care provider. - Ask your doctor or clinic whether you should have a test to .nd out if cancer genes were passed to you. - Delawareans can call 1-866-409-1858 toll free for help to quit smoking. Many Delawareans are eligible for free services. - Start eating more fruits, vegetables and other foods with less fat. - Increase how much you exercise. Walk more often, take the stairs. - Do not tan, indoors or out, and use sun block whenever outdoors. Clouds do not stop skin damage. - Have your home tested for radon gas. Call 302-744-4816 for free test kits. - Make your home healthier. Go to www.dhss.delaware.gov/dph/hsp/healthyhomes.html (Page 4) (Logo) DELAWARE HEALTH AND SOCIAL SERVICES Division of Public Health Information Resources For investigations by the Centers for Disease Control and Prevention visit: http://www.cdc.gov/nceh/clusters/investigations.htm The booklet Cancer and the Environment contains information about substances known or likely to cause cancer, and what can be done to reduce exposures. www.niehs.nih.gov/health/docs/cancer-enviro.pdf For Cancer Prevention visit the National Cancer Institute at: http://www.cancer.gov/cancerinfo/ or the CDC at: http://www.cdc.gov/cancer/ For questions or comments related to this document, contact the Division of Public Health as follows: Delaware Health and Social Services Division of Public Health 540 S. DuPont Highway, Dover, DE 19901 Phone: 302-744-1020 Fax: 302-739-2545 http://www.dhss.delaware.gov/dhss/dph/index.html Produced by DPH’s Office of Health and Risk Communications. Heidi Truschel-Light, writer/editor; Tamara Stock, graphic designer; photo by Dr. Paul Silverman. Doc. Control No. 35-05-20/08/12/12