Lung, colon cancer rates high in area
Lung and colon cancers are more likely to strike residents in the region north of Boston than in many other areas of Massachusetts, according to a new state health survey.
The report by the state Department of Public Health provides a sweeping view of the diseases, injuries, and deaths in a wide swath of suburbia from Everett up the North Shore to Salisbury, and over through the Merrimack Valley.
The 173-page report measures the prevalence of everything from AIDS and asthma to drug overdoses, obesity, and smoking as of 2005, based on the state's most recent figures.
While the report highlighted several areas of concern, it noted that, in general, Northeastern Massachusetts is a "relatively healthy place to live," with lower rates of hospitalization for diabetes and hypertension than most other areas of the state.
It also showed that the region has relatively low rates for homicides, sexually transmitted diseases, and HIV/AIDS.
The massive compilation of health information does not explain why local residents are disproportionately affected by lung and colorectal cancer s, but it does show that they are the least likely of any in the state to undergo one critical cancer screening -- a colonoscopy, which can detect colorectal cancer in its earliest and most treatable stages.
"The numbers say to me that we need to do more public education about colorectal screening and the importance of colonoscopies," said the state public health agency's commissioner, John Auerbach.
He is traveling around Massachusetts this month presenting the results of his department's regional health surveys and listening to residents' concerns and suggestions for improving the health of their neighborhoods.
One community that appears to need more help, Auerbach said, is Gloucester, which recorded the region's highest percentage of women who smoke during pregnancy -- 12.5 percent, compared with 7.2 percent statewide.
"There definitely seems to be a pattern of higher smoking levels in some of the fishing communities. We found that in the Fall River and New Bedford area, too," Auerbach said. "There are behaviors that are sometimes historical behaviors in communities."
Auerbach said state lawmakers appear likely to increase funding for tobacco - control education, and he said he will use the results of the new survey to help target the funds to communities, such as Gloucester, that seem to need the extra help.
Jack Vondras, Gloucester's Health Department director, said he could not explain the city's high percentage of pregnant smokers, but he said he has seen how tobacco - control efforts affect the sales of cigarettes to minors.
"Last year, I only did one round of tobacco-sales compliance checks because the funding was cut. As soon as I back off on compliance checks, they start selling again," Vondras said.
In the most recent round of checks, roughly a third of the stores surveyed were caught selling cigarettes to minors, compared with 10 percent in earlier surveys, when inspectors were able to check more frequently, Vondras said.
Overall, roughly 18 percent of adults in the region smoke tobacco, about the same as statewide, according to the new report. Those numbers don't sit well with Dr. David Rosenthal, past president of the American Cancer Society and an oncologist at the Dana-Farber Cancer Institute in Boston. Rosenthal said cancer specialists would like to see adult smoking rates below 10 percent, but they know it's an uphill battle.
"The data is suggesting it takes a lot of effort to convert adult smokers" to nonsmokers, he said, "so a lot of emphasis is being placed on preventing youths from starting to smoke."
It is hard to draw a conclusion about the region's higher-than-average lung cancer rate, Rosenthal said, because the state's report is more of a snapshot that only shows the percentage of adult smokers in 2005.
Specialists would need to study years of data, including the smoking history of the adults who developed lung cancer, to understand why the disease is disproportionately higher in area communities, he said.
But the picture is clearer when it comes to pediatric asthma.
The report shows the region's children have significantly lower rates of asthma and emergency room treatment for the disease, compared with their counterparts in many other areas of Massachusetts.
The notable exception is emergency room treatment for younger children in two of the region's poorest communities -- Lawrence and Lynn, with Lynn reporting the highest asthma ER rates in the region.
Lynn's rates are about 38 percent higher than the state average.
Asthma specialists say mounting evidence suggests that indoor air quality -- with dirt, mold, dust, and even cockroaches contributing to unhealthy conditions -- is a leading factor in asthma attacks in children, and that poorer communities with substandard housing are likely to see higher rates of pediatric asthma.
Dr. Edward Bailey, chief of pediatrics for the North Shore Medical Center network, calls the state's figures on asthma in Lynn and Lawrence a "blinking neon light" for healthcare providers.
"In health care, we tend to look at physicians, and rarely do we talk about how healthcare is so dependent on the communities in which the people are living," Bailey said.
A hospital committee that Bailey chairs meets regularly with a broad array of community leaders to discuss health issues and one that they are studying, he said, is how to improve Lynn's housing stock.
To view the Northeast Regional Report, go to mass.gov/dph/resep, and click on the Population Health Statistics link.
Kay Lazar can be reached at klazar@globe.com. 