After more than ten years of studies of Delaware's high cancer death rates by Delaware's Division of Public Health, few of the recommendations to reduce the excessive number of cancer deaths have been understood or adopted. Although rural Sussex County's cancer death rate is higher than the other two counties (except for lung cancer), and Delaware has only a few more cancers per population than the national average, industrial toxins commonly continue to be blamed for the State's high cancer mortality rate. People are still not persuaded that over the long run, cancer deaths would be cut by adopting healthy life styles to: 1. Reduce exposures to tobacco (by far the most significant intervention), 2. Stick to low fat, high fiber diets, 3. Have regular screening for cancers with appropriate tests 4. Seek medical attention for early symptoms of cancer. This review is seeking to emphasize the importance of implementing the repeated recommendations to reduce cancer mortality in Delaware without asking for another study, and to stress that health behavior education at home and in the schools is a cost effective way to initiate the adoption of healthy life styles to reduce the risk of getting cancer and dying from it. Efforts in the schools should be continued by extending health promotion activities to workplaces, doctors' offices, and to the general public with a focus on senior citizens. Universal access to health care will be needed especially for the poorly educated with limited fiscal resources who are most at risk. Delaware needs action, not more studies, to reduce its high cancer death rate.

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