Washington Ranked as the Nation’s Cancer Capital in Detailed Study

WASHINGTON —  Residents of this city are dying of cancer at a rate one-third higher than the national average, resulting in nearly 200 “excess deaths” from the disease annually in Washington, according to a new study that graphically documents how the city has become the cancer capital of the country.

One of the most striking pieces of data in the report was that black males in the District had the highest cancer death rates of all when compared with nine other cities with sizable black populations.

In the 1970s, the latest period for which such data was available, black men in the District died of cancer at a rate of 349 per 100,000 each year--compared with a rate of 270 black males in New York City, 259 in Atlanta, 268 in Detroit, and 232 in the entire United States. The black female cancer mortality rate of 172 per 100,000 was among the highest in the country, exceeded only by those of Baltimore and New Orleans.

Higher Rate of Cancer

The unpublished report by the D.C. Commission of Public Health, obtained recently by the Washington Post, shows that the District population overall has a higher rate of cancer deaths than any state in the country. Each year between 1980 and 1986, an average of 225 D.C. residents per 100,000 population died of cancer, compared with the national rate of 169 deaths per 100,000.

During the entire period studied, 1950 to 1986, the mortality rate among District whites declined by about 5%, while it increased 41% among black males. Cancer mortality also increased by 9% since 1960 among black females.

The study also suggested that high cancer rates are a problem across the metropolitan region, although they are less severe in the suburbs than in the District.

The epidemiologists estimated that there were nearly 500 “excess” cancer deaths annually in the region between 1970 and 1979. Excess deaths are those that would not have been expected to occur had the lower, national mortality rates prevailed.

Significant Statistics

The statistics are significant, experts said, because they suggest that the problem of high cancer rates in Washington cannot be attributed solely to socioeconomic factors.

While lack of access to primary health care and cancer screening--in part because of lack of health insurance--is undoubtedly a major factor in the high cancer rates, bad diet, smoking, high alcohol consumption and perhaps occupational and environmental factors also likely play a role, experts said.

“The cancers that are killing people--they are all preventable,” said Public Health Commissioner Reed V. Tuckson, who cited in particular excessive cigarette and alcohol use and the failure by many residents to undergo cancer screening. “When cancer is presented to a physician (in Washington), it is often too late to do something about it.”

Mystified by Findings

Other public health experts and cancer specialists said they were, to a certain degree, mystified by some of the findings, which were part of what officials said was the most comprehensive epidemiological analysis ever of cancer mortality in the District.

Dr. John J. Lynch, director of the oncology program at the Washington Hospital Center, said he was “shocked” by the differences between Washington and other cities and said, “It is sort of spooky.”

Drawing a comparison between Washington and Detroit, Lynch added: “With all the people involved in the auto industry and the pollution, I thought they would have been a lot worse than we are (in cancer mortality). But they are not. We are worse.”

Overall Rates Higher

Lynch, a member of the D.C. Cancer Consortium, a group of institutions involved in the fight against cancer, said his group is concerned that despite such dramatic differences, the city has not budgeted enough money for cancer prevention and screening. The city’s Bureau of Cancer Control is slated for a budget of $571,000 in 1990, or half of what Lynch said is needed to fund cancer activities adequately.

The study made clear that the cancer problem extends beyond the black community. The overall cancer mortality rates for white males and females in the District were above the national average, and for some cancers the rates were far in excess of the national average, the data showed. Between 1970 and 1979, the study showed, the breast cancer mortality rate for both black and white females was the highest in the country.

1,600 Deaths Annually

Dr. Claudia R. Baquet, chief of the Special Populations Studies Branch of the National Cancer Institute, noted that the prevalence of cancer is a special problem in black communities everywhere. “In D.C., there appears to be an extreme concentration of the problem,” she said. The problem of high cancer rates in Washington has long drawn attention from public health experts.

Cancer is the second leading cause of death in the District, accounting for nearly 1,600 deaths annually, or one of every four deaths. Half of these deaths are due to four types of cancer: lung, colon, breast and prostate.