Low-dose CT scans find lung cancer before X-rays, save lives

Low-dose computed tomography, commonly known as CT scans, are reducing lung-cancer deaths by finding the cancer early before it spreads to other parts of the body, UK HealthCare reports. Used as a screening tool, the American College of Radiology says CT is "the only test ever shown to reduce mortality in high-risk smokers."

This is good news for Kentucky, which leads the nation in both lung cancer and deaths from it.  It also leads, by some estimates, in smoking, the leading cause of cancer.  An estimated 25 to 28 percent of Kentuckians are smokers, compared to 18 to 19 percent nationally.

Low-dose CT screening for lung cancer is recommended for high-risk patients, defined in a Mayo Clinic article as someone 55 to 79 who's smoked the equivalent of a pack of cigarettes every day for 30 years, or those 50 and older who have smoked a pack a day or more of cigarettes for 20 years or longer and have one additional risk factor for lung cancer.

Chest X-rays, the other screening technique, typically are not done until a person has symptoms because studies have shown that they are not effective in detecting lung cancer early. However, researchers have found that heavy smokers screened with low-dose CT scans can pick up much smaller tumors than chest X-rays and have a "20 percent lower risk of dying from lung cancer than those screened with chest X-rays," UK HealthCare reports.

A recent study found that nearly one in five lung tumors detected on CT scans are probably so slow-growing that they would never cause problems, reports Lindsey Tanner of The Associated Press. These tumors are not false positives, but cancerous tumors without symptoms, which are unlikely to become deadly, according to the research. However, National Lung Cancer Screening Trial results conclude that the benefits from low-dose CT scans significantly outweigh the "comparatively modest rate of over-diagnosis," according to the American College of Radiology. "Overdiagnosis is an expected part of any screening program and does not alter the benefits you get from the screening,"

Dr. Paul Ellenbogen, chair of the American College of Radiology Board of Chancellors, said in the release, "Physicians should certainly discuss the risk and benefits of CT lung-cancer screening with patients – including that of overdiagnosis. However, for high-risk patients, the group in which CT lung cancer screening is proposed, the lifesaving benefit outweighs the risks."

Kentucky spends less than a penny of its tobacco-settlement money on prevention programs; few states do very much

By Molly Burchett
Kentucky Health News

A new report says that 15 years after the 1998 state tobacco settlement, Kentucky ranks 38th in the nation in funding tobacco prevention and cessation programs, only 3.7 percent of the amount recommended by the federal Centers for Disease Control and Prevention.

The CDC recommends that the state spend $57.2 million a year on programs to help people quit smoking, but Kentucky is only planning to spend $2.1 million in 2014 on them, says the new annual report from the Campaign for Tobacco-Free Kids. Last year's report ranked Kentucky 37th as it planned to spend the same amount.

The goal of these programs is to help kids and adults quit smoking. Of the $320.3 million in revenue the state will get from the settlement in the current fiscal year, Kentucky will spend just 0.7 percent of it on tobacco-prevention programs, or less than a penny of every dollar it collects in revenue, the campaign says in a news release and a chart.

Kentucky has the highest smoking rates in the country, a an estimated 28.3 percent of adults and 24.1 percent of high-school students smoke. Each year, tobacco claims 7,800 lives and costs the state $1.5 billion in health care bills, about $487 million of which are covered by the federal-state Medicaid program, and each Kentucky household pays an estimated $582 per year in taxes to cover smoking-caused government expenditures, the release says.

To reduce smoking and its negative consequences, health advocates are calling on Kentucky leaders to pass a comprehensive, statewide ban on smoking in workplaces and enclosed public spaces. Some advocates also call for an increase in the state's tobacco tax. The report says Kentucky has the 40th lowest cigarette tax in the country at 60 cents per pack, 93 cents below the state average. It was doubled a few years ago.

"Tobacco takes a terrible health and economic toll on Kentucky, but state leaders can do something about it by increasing funding for tobacco prevention and passing a comprehensive, statewide smoke-free law," said Matthew L. Myers, president of the campaign. "The evidence is clear that reducing tobacco use not only saves lives, it also saves money by reducing tobacco-related health care costs. It's one of the smartest investments Kentucky can make."

Nationally, the report finds that most states are failing to adequately fund tobacco prevention and cessation programs. States will collect $25 billion from the tobacco settlement and tobacco taxes in 2014, but will spend just 1.9 percent of it on prevention programs.

States are spending only 13 percent of the CDC's recommended $3.7 billion in funding for these prevention programs, and only two states – Alaska and North Dakota – spend the recommended amount.

Green = State spends 50 percent or more than recommended amount; Orange= 25-45 percent of recommended amount; Yellow = 10-24 percent of recommended amount; Gray = less than 10 percent of recommended amount 

"Tobacco use is the number one cause of preventable death in the U.S., killing more than 400,000 people and costing $96 billion in health care bills each year. Nationally, about 18 percent of adults and 18.1 percent of high school students smoke." says the report.

Since the states settled their lawsuits against the tobacco companies in November 1998, the Campaign for Tobacco-Free Kids has issued annual reports to hold states accountable for settlement spending, an amount estimated to be $246 billion over the first 25 years.

The annual report on states' funding of tobacco prevention programs, titled "A Broken Promise to Our Children: The 1998 State Tobacco Settlement 15 Years Later," was released by the campaign, the American Heart Association, the American Cancer Society Cancer Action Network, the American Lung Association, the Robert Wood Johnson Foundation and Americans for Nonsmokers' Rights.

'Faces of Lung Cancer' photo exhibit at Markey Cancer Center is meant to spread awareness about disease and its prevention

Lung cancer survivor Juanita Meade

"Faces of Lung Cancer," a photo exhibit with portraits and inspirational messages from nine lung cancer survivors in Kentucky, is on display at the University of Kentucky Markey Cancer Center on the 1st floor atrium of the Combs Research Building, 800 Rose St., until Monday, Dec. 16.

This exhibit was coordinated by the Kentucky Cancer Program to spread awareness about lung cancer and prevention, according to a UK press release.

Lung cancer kills more Kentuckians every year than the next eight most common cancers combined, and Kentucky leads the nation in both lung cancer and deaths from it, and by some estimates also leads in smoking, the leading cause of lung cancer.

An estimated 25 to 28 percent of Kentuckians are smokers, compared to 18 or 19 percent nationally.

Kathy Sinclair, lung cancer survivor

And while tobacco use increases your risk, the UK release notes that anyone can develop the disease: "Lung cancer kills nearly twice as many women as breast cancer, and is the leading cause of cancer deaths for both men and women in the U.S."

Symptoms are generally not noticeable in the early stages of lung cancer, according to UK's Health Education through Extension Leadership newsletter.

Signs and symptoms of lung cancer include:
• Chronic cough
• Hoarseness
• Coughing up blood
• Weight loss
• Loss of appetite
• Shortness of breath
• Unexplained fever
• Wheezing
• Repeated bouts of bronchitis and/or pneumonia
• Chest pain

Great American Smokeout is Thursday, Nov. 21, featuring supportive characters to share on social media and a Twitter chat

The American Cancer Society's annual Great American Smokeout will be held Thursday, Nov. 21. The event encourages smokers to quit smoking, or make a plan to quit smoking, that day.

Quitting, even for one day, according to the Cancer Society, is an important step toward a healthier life, one that can lead to reducing cancer risk.

In Kentucky, according to the Centers for Disease Control and Prevention, 25.2 percent of adults are cigarette smokers, second highest in the nation. The Kentucky Tobacco and Cessation Program reports that each year more than 8,000 Kentuckians die of illnesses caused by tobacco use.

"Tobacco use remains the single largest preventable cause of disease and premature death in the U.S., yet nearly one in every five adults smoke," the Cancer Society says. It also notes that there are 13.2 million cigar smokers in the U.S. and 2.2 million who smoke tobacco in pipes, which are also dangerous and addictive forms of tobacco.

To celebrate quitters and their supporters, the American Cancer Society has designed a series of characters available to share on social networks. (See characters.)

They are also hosting, with Sharecare, a Great American Smokeout Twitter Chat on Wed., Nov. 20. This event allows you to post questions on Twitter to  @Sharecarenow  about how to quit smoking, smoking legislation or anything on your mind related to smoking.  You can also submit questions on Sharecare’s Facebook page.  The answers from the Cancer Society and other experts will roll out on Twitter at #quitforgood on Thurs., Nov. 21, between 11 a.m. and 4 p.m.

The health benefits of quitting are greater if you quit when you are young, but quitting at any age is beneficial. The Cancer Society lists the benefits chronologically:

• In 20 minutes: your heart rate and blood pressure drop
• In 12 hours: the carbon monoxide level in your blood drops to normal
• 2 weeks to 3 months: your circulation improves and your lung function increases
• 1-9 months: coughing and shortness of breath decrease
• 1 year: your risk of coronary heart disease is cut to half that of a continuing smoker
• 5 years: risk of certain cancers is cut in half, and stroke risk can fall to that of a non-smoker
• 10 years: the risk of dying from lung cancer is about half that of a person who still smokes and other cancer risk decrease
• 15 years: the risk of coronary heart disease is that of a non-smoker

The American Cancer Society is available to offer steps to quit smoking and to provide quit-smoking programs. To learn about the available tools, call 1-800-227-2345.

Hard-hitting TV ads against smoking do motivate smokers, like one mother from Elizabethtown, to quit

Hancock with CDC Director Tom Frieden

A 38-year-old Elizabethtown mother's response to a federally funded anti-smoking advertising campaign has been featured in national news this week, showing that these graphic ads can motivate smokers to quit.

Lisha Hancock's decision to stop her two-decade smoking habit was sparked by her viewing of a Centers for Disease Control and Prevention’s “Tips from Former Smokers” campaign commercial, reports Sarah Bennett of The News-Enterprise in Elizabethtown.

Hancock's husband often urged her to quit, and several of her relatives died from smoking, but she still didn't quit. She continuously had a sore throat and clogged sinuses, but she still didn't quit. Then, she saw the commercial.

The advertisement featured raw images of Terrie Hall, a North Carolina woman who was diagnosed with throat and oral cancers at age 40, getting ready in the morning by putting on a wig, artificial teeth an an artificial voice box inside a small hole in her neck, since throat cancer forced her to have her larynx removed.

TV spokeswoman Terrie Hall with grandson's picture

"The only voice my grandson’s ever heard is this one,” Hall says in a robot-like voice, displaying his picture. UPDATE: Hall died Sept. 16.

The ad made a lasting impression on Hancock, who told Bennett she decided to quit smoking after watching the ad with her son: “One time my son asked me, ‘Mom, why does her voice sound like that?’ I said, ‘Because she smoked.’ Then he asked, ‘So you’ll sound like that?’”

Hancock said she had tried to quit before, but "There's nothing that touched me like Terrie's ad. It definitely impacted my life and, in return, impacted my family's life. We all live happier and healthier now."

Hancock started to quit eight months ago. Using nicotine lozenges and a combination of exercise and healthful eating, she's been able to go without even one cigarette, reports Anahad O'Conner of The New York Times.

Others have also been struck by this hard-hitting campaign, which may have prompted more than 100,000 Americans to quit smoking permanently, says a new CDC study published in The Lancet, the leading British medical journal. The CDC says an estimated 1.6 million U.S. smokers attempted to quit this past year after viewing campaign materials funded by the Affordable Care Act.

"Hard-hitting ads work," said CDC Director Dr. Tom Frieden. The agency paid approximately $50 million to produce and place the spots, the first time the federal government funded a nationwide tobacco-education ad campaign, reports Jonathan Serrie of Fox News.

"The impact is huge because a smoker costs about $2,000 more [per year] than a non-smoker, and about $1,000 more than an ex-smoker, to care for," Frieden said. "And if you do the math, this program pays for itself in a year or two in reduced health-care and societal expenditures."

The campaign also saved an estimated 300,000 years of life that smoking-related diseases would have taken, reports Brady Dennis of The Washington Post. Smoking remains the leading cause of preventable death in the United States, killing more than 1,200 Americans each day, says the CDC.

Click here for the CDC ads and other smoking-cessation resources.

UK, with magnet of National Cancer Institute designation, attracts 4 researchers and their $17 million in funding from U of L

"A month after the University of Kentucky announced it is home to the state’s first National Cancer Institute-designated cancer center, an internationally recognized research team studying the role metabolism plays in cancer is leaving the University of Louisville for its chief in-state rival," Laura Ungar reports for The Courier-Journal. "The four researchers . . . will bring with them more than $17 million in federal funding over five years."

UK officials told Ungar they didn't recruit the researchers, and a U of L official said the school made "a significant counter-offer." But one of the researchers told Ungar that UK offered new equipment, new laboratory space and an opportunity to work with a wider group of collaborators.

"One area the scientists have been researching is lung cancer, which strikes and kills Kentuckians at the nation’s highest rate," Ungar writes. "Their work includes a newly funded project from the National Cancer Institute on biochemistry in lung cancer." (Read more)

Markey Cancer Center at UK gets National Cancer Institute designation, opening up new treatment options for patients

The University of Kentucky annouced Friday that its Markey Cancer Center has earned a prestigious National Cancer Institute designation. With this designation, the center becomes one of 68 in the U.S., and the only one in Kentucky, with special access to clinical trials, new treatments and new drugs for patients.

Kentucky ranks first in the nation in cancer deaths per 100,000 residents, and cancer is especially problematic in Appalachia, where the overall cancer rate is 12 percent higher than in the United States.

The designation signifies national excellence in clinical care and cancer research, a UK news release said. It allows Markey patients to join specialized drug or treatment trials that are open only to NCI centers, and it also opens up funding for researchers at UK, said Michael Karpf, UK's executive vice president for health affairs.

"It's the ultimate recognition for academic cancer centers," Markey Executive Director Mark Evers said. It will help UK battle cancers that plague the state, particularly lung and colorectal cancers, Evers said in a story by Linda Blackford of the Lexington Herald-Leader. To earn the designation, the center had to pass a rigorous review that began four years ago and will be renewed every five years, says the UK release.

UK officials said the designation will boost the state and local economy through research funding, and advanced cancer research could also generate more high-tech, health care jobs in the state.  "It strengthens Markey’s reputation as a frontrunner in cancer treatment and research," the UK release said.

CDC: Kentucky grossly underuses tobacco settlement money when it comes to tobacco prevention and cessation programs

Kentucky is not even remotely up to snuff on state tobacco-prevention programming. According to a new report from the Robert Wood Johnson Foundation and the Centers for Disease Control, the state spends only $2.2 million on such programs. That amount is only 4.5 percent of what the CDC recommends that state, which has the highest incidence of tobacco use in the nation, spend. If the state spent what the nation's most prestigious health institution recommended, state spending to improve Kentucky's collective lungs should be in the $57 million range.

Kentucky ranks 36th in state tobacco control spending nationwide. According to the RWJ Foundation report, states will collect a record $25.7 billion in revenue from the tobacco settlement and from tobacco taxes this year, but will spend just 1.8 percent of that money on programs to prevent kids from smoking and help smokers quit. That's less than two cents of every tobacco dollar sent back to the states. Only Alaska and North Dakota are funding the levels that the CDC has recommended.

Read the report here. To view an interactive national map, with each state's spending outlined at here.

American Lung Association calls state's tobacco-cessation benefit inadequate now that Medicaid is under managed care

Kentucky added a robust tobacco cessation benefit to its Medicaid program, only to lose much of it in 2011 by putting the program under managed care by insurance companies, the American Lung Association notes in its annual report. Not only do their plans offer fewer treatments, explained the report, but information was confusing to patients and healthcare providers alike. The report also notes that the state -- which is not alone in this -- offers its smokers who desire to quit inadequate access to medications and counseling.

Robert Preidt of HealthDay reports that the U.S. Department of Health and Human Services late last month published a proposed rule that requires tobacco cessation as an essential health benefit under the Patient Protection and Affordable Care Act. The lung association report how states could put that rule to maximum use. "Giving all smokers access to a comprehensive cessation benefits is not only the right thing to do, it's the smart thing to do," Billings said. "The bottom line is that quitting smoking saves lives and saves money." One recent study, reports Preidt, showed that providing smokers with help to quit has a three-to-one return on investment, meaning $3 is saved for every for $1 spent. (Read more)

To see more about how Kentucky's tobacco cessation coverage rates, according to the American Lung Association, go here.

Study: Raising cigarette taxes does curb even heavy smoking

The more you raise cigarette taxes, the less people smoke. That presumption was confirmed this week in a study by the Washington University School of Medicine in St. Louis. This has some resonance in Kentucky, where just last week the state’s Blue Ribbon Commission on Tax Reform told Gov. Beshear the state should raise taxes on tobacco, to $1 per pack from 60 cents. Other forms of tobacco would get a corresponding tax hike, reports Beth Musgrave of the Lexington Herald-Leader. The changes would raise an estimated $120 million in revenue and, if the research is right, cut down on long-term health care costs.

The researchers are the most adamant about the last point. “Most clinicians and researchers thought these very heavy smokers would be the most resistant to price increases,” says study author Patricia A. Cavazos-Rehg, PhD. “But our study points out that, in fact, change can occur. And that’s very good news.” In fact, in states where taxes on tobacco products rose by at least 35 percent, heavy smokers -- who averaged 40 cigarettes a day or more -- lowered their daily smoking by 14 cigarettes, on average.  In real numbers, the price for a pack of cigarettes increased from an average of $3.96 in 2001 to $4.41 in 2004. (Read more)

In Kentucky last year, almost 30 percent of residents said they were smokers, the highest in the nation. The state also has the highest rates of diabetes and lung cancer, reports Jim Malewitz of Stateline News. Kentucky’s cigarette tax is also among the country's lowest.

Women who smoke triple their risk of dying early, but quitting early enough might just wipe out that risk

A new study of more than a million women found that smokers have more than triple the risk of early death than nonsmokers, and that quitting can virtually eliminate the increased risk. Smoking is still the most preventable cause of death in the United States and the United Kingdom.

The University of Oxford study, published this week in the British medical journal The Lancet, included 1.3 million women between the ages of 50 and 65, making it one of the largest ever conducted on smoking. At the start of the study, in 1996, 20 percent of the women were smokers, 28 percent were former smokers and 52 percent had never smoked. "Each of the women was registered in the U.K.’s national health system, so their deaths and cause of death were recorded," explains Alexandra Sifferlin of Time magazine. "By 2011, 66,000 had passed away." Researchers found that even smokers who smoked as few as nine cigarettes a day had twice the mortality rate of nonsmokers.

"More encouraging, however," writes Sifferlin, "was the positive effect that quitting seemed to have on the women’s life span. Those who quit smoking before they reached 40 avoided more than 90 percent of the increased risk of premature death from cigarettes, while women who stopped even earlier -- before age 30 -- avoided 97 percent of the added risk." (Read more)

Cigarette companies balking at Justice Dept's request for "confessional" advertising that they say goes too far

Calling them "forced public confessions," America's largest tobacco companies are asking a federal judge to reject the government's proposed corrective statements for cigarette advertising. Fred Frommer reports for the Associated Press that the Justice Department has responded by saying that such statements need to be strong enough to protect people from future false declarations made by cigarette makers. The statements that the tobacco industry views as "going too far" include admissions that the companies lied about the dangers of smoking, the addictiveness of nicotine, the lack of health benefits for "low-tar" and "light" cigarettes and the negative effect of second-hand smoke. U.S. District Judge Gladys Kessler, who is hearing the case, has already said "she wants the industry to pay for corrective statements in various types of ads," writes Frommer. (Associated Press photo)

Judge Kessler ruled in 2006 that America's largest cigarette makers had systematically concealed the dangers of smoking for decades and that, as assurance that the crime was not repeated, such statements as a requirement in tobacco advertising would be appropriate. An example of an advertising statement under consideration, as suggested by the Justice Dept.: "For decades, we denied that we controlled the level of nicotine delivered in cigarettes. Here's the truth: Cigarettes are a finely tuned nicotine delivery device designed to addict people." At Monday’s hearing, Kessler said she doesn’t have to take the government’s proposed statements word-for-word, and will come up with “modifications.” (Read more)

Hopkinsville council, absent a proponent, narrowly replaces smoking ban idea with plan to require posted smoking policies

The effort to pass a smoking ban in the largest Kentucky town without one may have hit a roadblock Thursday night. The Hopkinsville City Council forwarded a smoking ordinance that would merely require businesses to decide whether to allow smoking and post signs at every entrance announcing its policy. The council's vote as a committee of the whole was 6-5, and the one absent council member favors a typical smoking ban.

Mayor Dan Kemp, who can vote to break council ties and does not sit on the committee of the whole, "said after the meeting that he could not support the proposal because it leaves the current law unchanged," Carla Jimenez reports for the Kentucky New Era. The alternative ordinance is scheduled for first reading Sept. 18; a tie vote would block it, and a tie vote in favor of a smoking ban could be broken by Kemp to pass it.

As first presented to the committee, the ordinance would ban smoking in public places, with exemptions for private clubs, age-restricted establishments and businesses with 12 employees or fewer. The small-business exemption was removed on a vote of 10-1. "That left the ordinance as it originally came before the council for its first reading in June," Jimenez reports. But then the committee voted 6-5 for the alternative ordinance, proposed by Councilman Paul Henson, who argued, “We’re not abusing anybody’s rights. We’re not the bad guy, and yet we have the smoking ban, a smoking ordinance, on the books.”

Councilwoman Peggy Rogers-Everett disagreed, saying smoking is a hazard to everyone, and “Murder is illegal.” Henson and Councilwoman Ann Cherry and Henson laughed, and "Everett was not amused," Jimenez reports. Everett said, “I don’t find that funny. I don’t take that lightly.” (Read more)

State health department starts new ad campaign against secondhand smoke, including three 15-second TV commercials

The Kentucky Department for Public Health is launching a new campaign to educate Kentuckians about the dangers of secondhand tobacco smoke and its potential effect. The campaign is funded by $281,000 from the economic stimulus package of 2009 and about $90,000 from the federal Centers for Disease Control and Prevention. This week the department will start running television, billboard and radio advertisements to show the dangers of smoke that comes from the burning end of cigarette, cigar or pipe or the exhaled smoke from a smoker. The ads, which will run statewide, highlight the link between secondhand smoke and dangerous illnesses in both adults and children.



The ads, produced by Louisville-based Doe-Anderson, feature people being unwillingly exposed to secondhand smoke in places such as residences and cars. Each ad carries the tag line, “Secondhand smoke is 100 percent unsafe, 100 percent of the time.”

Kentucky’s smoking rate remains the second highest in the country, with 24.8 percent of the adult population identified as current smokers, and secondhand smoke exposure is equally high. The health department says 39.5 percent of Kentucky children live with someone who smokes – the highest percentage in the country. Secondhand smoke has become a major public health concern because it contains approximately 4,000 chemicals, many of which are known carcinogens, and is responsible for approximately 3,000 cases of lung cancer deaths among nonsmokers each year.



The campaign is another project of the Kentucky Tobacco Prevention and Cessation program. Community interventions for tobacco cessation are available through local health departments staffed with tobacco control specialists, and the program operates a toll-free telephone line, 1-800-QUIT NOW. It also provides technical assistance, with the Kentucky Center for Smoke Free Policy at the University of Kentucky, to assist communities in seeking smoke-free ordinances.

New cigarette warning labels to be in use by fall 2012

Showing graphic photos of rotting teeth, a man with a zipper-like scar down the length of his chest and even a man with smoke coming out of his tracheotomy tube, the Food and Drug Administration unveiled this week the warnings that will be required on cigarette packages starting in fall 2012.

The move is aimed at getting smokers to quit, which could be especially beneficial in Kentucky, where 25 percent of adults are smokers, compared to 18 percent nationwide. The state has the second highest smoking rate in the country, data from the Centers for Disease Control and Prevention show.

The FDA hopes the images "will reduce the number of smokers by 213,000 by 2013 and save between $221 million and $630 million every year over the next 20 years," Rob Stein of The Washington Post reports. "With these warnings, every person who picks up a pack of cigarettes will know exactly what risk they are taking," Health and Human Services Secretary Kathleen Sebelius said.

The graphics, which represent the first time U.S. warnings have been overhauled in 25 years, are accompanied with messages such as "Warning: Cigarettes are addictive" or "Warning: Smoking can kill you." Warnings started appearing on cigarette packages in 1966, but remained limited to small text on the sides of packages and in ads. About 30 other countries, including Canada and Brazil, already require graphic warnings.

To prevent smokers from becoming desensitized to the images, the FDA plans to conduct studies to make sure the images are still having an effect. "What may seem quite shocking at the beginning, people get used to quite quickly," Sebelius said.

Several tobacco companies are challenging the move in court. They would not comment about the images, Stein reports. (Read more)

As for whether they will make a difference, Washington Post columnist Petula Dvorak polled some smokers, who seemed unfazed by the images. (Read more)

Kentuckians think cancer is biggest threat to adults, but heart disease kills more men in the state

Cancer is the leading health concern identified by Kentuckians, and is the principal cause of death among women in the state, though heart disease is the main killer of Kentucky men, the Kentucky Health Issues Poll found.

Thirty-six percent of Kentucky adults identified cancer as the most important health issue for men, followed by heart disease at 31 percent, according to a news release for the Foundation for a Healthy Kentucky, which co-funded the poll. Heart disease was the leading cause of death for Kentucky men in 2009, followed closely by cancer.

Only about 7 percent of Kentuckians identified obesity as the top health issue facing Kentucky adults, but 29 percent said it was the greatest concern for children, perhaps reflecting considerable public attention to concern about child obesity. "While childhood mortality is rare, there are lifelong health implications that can be linked to struggling with obesity and diabetes at an early age," the release said.

“Even though the results suggest some confusion about our biggest health threats, there are ways to reduce Kentucky’s chronic disease risks: eat healthy foods, exercise regularly, stop smoking or don’t start,” said Dr. Susan Zepeda, CEO of the foundation, which co-sponsored the poll with the Institute for Policy Research at the University of Cincinnati. The poll interviewed a random sample of 1,677 adults, 1,469 by landline phones and 208 via cell phones. In 95 of 100 cases, the estimates are accurate within a 2.4 percent margin of error. To see the report, click here.

State health commissioner encourages smoke-free ordinances

Kentucky's public health commissioner said communities are moving in the right direction by enacting smoke-free ordinances and hopes Kentucky can become a smoke-free state. "We have communities in Letcher County, as well as areas in far Eastern Kentucky, Western Kentucky and Northern Kentucky implementing second-hand smoke ordinances because it's dangerous for people who are non-smokers," Dr. William Hacker said.

Hacker, who spoke at the Breathing Clean Air Summit in Owensboro Thursday, said 25 percent of Kentuckians smoke, the highest percentage in the country, reports Jasmin Embers of WFIE-TV in Evansville. "We're ranked number one in lung cancer deaths, so if you're number one in smoking, you can expect to be number one in lung cancer deaths," Hacker said.

Hacker encouraged communities that already have smoke-free efforts or laws to go farther. Change can be seen at Owensboro Medical Health System, which now has four smoking huts on its campus. Those will be eliminated by the end of the year, a move that was decided after employees responded to a smoking survey. "Half of the respondents said they felt that smoking on OMHS grounds contradicted our mission statement to heal the sick and improve health of our community," wellness committee member Gordon Wilkeron said. (Read more)

Kentucky continues to lead nation in cancer death rate

Though cancer deaths rates are falling nationwide, Kentucky continues to rank worst in the country for its number of cancer deaths, The Courier-Journal's Laura Ungar has determined. (C-J graphic shows rates for the nation, Kentucky and Indiana, the southern part of which the Louisville newspaper serves.)

Ungar's analysis stems from Thursday's release of the Annual Report to the Nation on the Status of Cancer, which concluded cancer death rates declined about 1.6 percent each year between 2003 and 2007 nationwide. Kentucky's death rate declined an average of 0.7 percent each of those years.

The state had a cancer death rate of 213.7 per 100,000 residents in 2007, which translates to about 9,700 Kentuckians dying each year from cancer. In 2007, Kentucky had a lung cancer death rate 50 percent higher than the national average, ranking it highest in the nation. It also ranked eighth highest in brain and other nervous-system cancers and higher than average for colorectal, prostate and breast cancer death rates.

Lung cancer is the most deadly cancer in the country, though researchers found, for the first time, a decrease in the number of women who die from lung cancer nationwide. The decline comes "more than a decade after deaths began dropping in men," Ungar reports.

Doctors are hoping to make more strides in battling the disease in the years to come. Thomas Tucker, director of the Kentucky Cancer Registry, told Ungar that smoking bans, higher cigarette taxes and anti-smoking messages should help drive down lung cancer rates. There has also been progress in the percentage of Kentuckians who are getting colonoscopies, a screening for colon cancer. Though more Kentuckians died of colorectal cancer than any other state in 2007, the rate has declined since. (Read more)