COLUMBIA, S.C. - Cancer patients face a higher risk of death in South Carolina compared with the rest of the country, according to the state's first report card on the disease.

While the state received a failing grade for cancer deaths, it also received the top grade from the South Carolina Cancer Alliance on Friday because the overall risk of developing the disease was lower than the national average.

The statewide nonprofit group that works to curb cancer in the state reviewed 19 cancers that appear problematic in South Carolina. The report card will serve as a guideline for how the state handles cancer occurrences, death rates and disparities.

The alliance will release a plan next spring hoping to reduce the impact of cancer in the state. One out of five South Carolinians is likely to develop cancer in their lifetime, the report said.

"I expected to see significant problems in incidents and mortality and disparity in our state, but actually seeing it in print, in black and white, it was shocking," said Dr. Terry Day, the chairman of the coordinating committee for the alliance.

Lung cancer was the most commonly diagnosed cancer in the state. It accounted for 30 percent, or 2,481, of all cancer deaths in 2002, the report said. Most lung cancer deaths are attributed to smoking or secondhand smoke.

South Carolina's death rate could be lower with detection through routine screenings and preventative behavior, the report said.

Day, whose also a professor at the Medical University of South Carolina, blames everyone in the state for not doing enough. He also would like to see more money spent on smoking prevention.

South Carolina ranks at the bottom of surveys that rate how much state money is being spent on prevention programs. North Carolina had $6.1 million and Georgia had $12.6 million to spend on tobacco prevention last year, according to a survey by the Campaign for Tobacco-Free Kids.

The state has received millions in tobacco settlement money, but most of the state's settlement has been spent on health care or given to tobacco farmers.

"Obviously our state has not been as progressive as many states in reducing the risk factors such as tobacco," Day said. "There are a number of states who have received millions of dollars through state government legislation that has been allocated to cancer control."

The report also notes disparities between gender and race. Black women in the state were much more likely to die from breast cancer than white women, and black men were more likely to die from colorectal, esophageal, oral and prostate cancers than white men.

Day said he expected to see a high death rate in lung cancer, but was surprised to see high rates and disparities in breast, colorectal and prostate cancers.

Gov. Mark Sanford, who has challenged South Carolinians to live healthier lifestyles, said the report card paints a grim picture of the cancer problem in the state.

"Many of us have experienced cancer through the eyes of a loved one and understand that cancer is just not about statistics," Sanford said in a letter in the report.

Sanford's wife, Jenny, has been working with the alliance since its inception two years ago.

"Cancer is devastating for so many families in South Carolina. It is important that we develop community-wide partnerships bringing together experts with a passion to fight this disease," the first lady said in a statement. "We have the baseline data. We can now begin to implement programs across the state and track the success of our efforts."

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View the report card: http://www.sccanceralliance.org/