Hagerstown, Md. (AP) - Cancer respects no boundaries but its effects can be mapped.

In western Maryland, mouth cancers occur more frequently and at an earlier age than in Baltimore, where prostate cancer is a bigger problem. In some Eastern Shore communities, more people are diagnosed with multiple cancers than those in other parts of the state. The University of Maryland Statewide Health Network is using that knowledge to help local medical professionals tailor disease prevention to their community's characteristics under a program funded by the 1999 tobacco lawsuit settlement. The network, which opened its fifth outreach office this month in Hagerstown, seeks to more effectively disseminate useful information about cancer and tobacco-related diseases. Organizers hope to reduce both the number of deaths from those ailments and the disparity in cancer deaths between whites and blacks. The project is funded by a 10-year, $3.5 million grant from Maryland's share of a $206 billion settlement negotiated in 1999 between the tobacco industry and 46 states. The state is to receive $4.4 billion through 2020. Since July 2000, the health network, based at the University of Maryland's Baltimore medical center, has established outreach offices in some of the state's poorest areas - Hagerstown, LaVale, Salisbury, Chester and Baltimore city. "The importance of establishing regional offices is that it allows us to look at the needs in a more focused way, so the needs are addressed in a more targeted manner that would be more relevant and appropriate for the population in that community," Meseret Bezuneh, an associate director of the network, said. For example, the network helped organize a mammography project called "You Ought to be in Pictures" in Somerset County using billboards and posters targeting black women. Black women in Maryland have a higher breast cancer death rate despite having a lower incidence of breast cancer than white women. In western Maryland, the network joined with local health departments to bring an oral cancer survivor into public schools to talk about the danger of chewing tobacco, Bezuneh said. Cancer is the second-leading cause of death in Maryland, responsible for 24 percent of deaths in 1999, according to the most recent Maryland Department of Health and Mental Hygiene report. The cancer incidence - 477 per 100,000 Marylanders - is slightly higher among whites than blacks, probably reflecting better screening. But Maryland blacks outnumber whites in cancer deaths - 257 per 100,000 versus 204 per 100,000 whites. "This network provides an opportunity to intervene in order to reduce these cancer disparities," said Denise Harmening, a professor of medical research technology at the University of Maryland School of Medicine. The network also offers local doctors and nurses access to the University of Maryland's telemedicine system, enabling face-to-face discussions with top experts at the medical school and at Johns Hopkins. Washington County Health Officer William G. Christoffel said he looks forward to participating in the network. "We've had a fairly successful program in reaching the community for colon cancer, but when you look at the other cancers - skin cancer, oral cancer - we haven't had the resources really to do the outreach for both of those and to educate the community," he said.

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