Gauntlet laid down on cancer Health secretary challenges citizens


Maryland's top health official issued a call to arms against cancer yesterday, saying the state has mobilized resources needed to reduce its worst-in-the-nation cancer death rate but still has to persuade citizens to use them.

Health Secretary Nelson J. Sabatini told 500 people gathered at the state's first "cancer summit" that laws making mammograms and Pap smears available at little or no cost to most state residents should have the effect of reducing deaths from breast and cervical cancers.

The past year has seen enactment of state laws mandating insurance coverage of mammograms, Medicaid coverage of mammograms and Pap smears, and financial incentives for hospitals to offer low-cost or free screenings to women who lack health insurance. Meanwhile, Medicare now covers mammograms for the elderly.

But despite the availability of preventive measures, people in large numbers have not taken advantage of them, Mr. Sabatini said.

"I don't know what it is," he said. "Human nature is such that a lot of people don't want to go in for tests."

In months to come, one of the state's main strategies against cancer will be to mobilize churches, citizens' groups and corporations to tell people that some cancers can be cured if caught early, he said.

"We need to capture them and bring them into the system," Mr. Sabatini said.

The cancer summit, held at Martin's West, included an impassioned speech by Marilyn Tucker Quayle, wife of Vice President Dan Quayle, who said her mother's death at age 57 from breast cancer has motivated her to urge women to get mammograms. Her mother, Mary Alice Tucker, died in 1975.

"This disease deprived my three children of even knowing what a wonderful woman my mother was," she said.

The all-day event was sponsored by the Governor's Council on )) Cancer Control, a panel named by Gov. William Donald Schaefer last year after the publication of government statistics showing Maryland had the nation's highest cancer death toll.

In Maryland, 191 out of every 100,000 people died of cancer in 1989, compared with a national average of 171 per 100,000. The figures, from the National Cancer Institute, are the most recent available.

The state ranks among the top six states in deaths from lung, colon, breast and prostate cancers, and ranks among the top four in deaths from cancers of the esophagus, larynx, pharynx, bladder and bone marrow.

Mr. Sabatini and Governor Schaefer also promised a heightened campaign of public education against smoking, a leading cause of lung cancer as well as heart disease. Maryland has the fourth highest per-capita consumption of cigarettes in the nation.

Unlike many other cancers, lung cancer is hard to cure even if it is caught early. Dr. Joseph Aisner, director of the University of

Maryland Cancer Center, said the prognosis is so poor for lung cancer victims that only nine out of every 100 victims are alive five years after their diagnosis.

Dr. Aisner joined the governor and health secretary in railing against cigarette ads, particularly those targeting youths and minorities -- two groups whose smoking rates remain stubbornly high.

Governor Schaefer rejoiced in this year's enactment of a 20-cent increase in the tobacco tax, and suggested that tobacco companies contribute one penny toward cancer research for every penny spent on advertising. Earlier this year, the General Assembly raised the cigarette tax from 16 cents a pack to 36 cents. The increase went into effect May 1.

And Mr. Sabatini hinted that the administration may propose an even higher tax on cigarettes.

"We beat them good and we're going to go back and do more to them," he said. "It's an industry that has the social conscience of a garden slug."

A longtime smoker who is trying to quit, Mr. Sabatini said separately that use of a nicotine patch has helped him go four months without a cigarette.

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