DOVER — Delaware’s cancer rate continues to decline, state officials said Monday.

From 1999-2003 to 2009-2013, the cancer death rate decreased 15 percent, a slight improvement over the national average of 14 percent, according to Division of Public Health officials.

Delaware ranked ahead of 15 states in cancer mortality rates. It was second-worst overall in the 1990s.

However, at 176.1 deaths per 100,000 people, the state’s mortality rate was still higher than the U.S. rate of 168.5 for 2009-2013.

DPH presented the new report to the Delaware Cancer Consortium Monday, highlighting changes over the past few years.

“Delaware is making great progress in battling the deadly disease of cancer in our state,” Gov. John Carney said in a statement. “This report shows our successes, but also shows us we have more work to do.”

From 2009-2013, the state saw 507.3 people diagnosed with cancer per 100,000 people, a rate greater than the national average.

The rate fell for men and black individuals but rose for women and white Delawareans. Cancer rates are lower among Hispanics than the general population.

“I’m pleased that we are seeing some successes, particularly in the African-American and Hispanic communities,” DHSS Secretary Kara Odom Walker said in a statement. “However, there is still more we need to do to eliminate disparities for African-Americans, particularly when it comes to earlier diagnosis of breast cancer. DHSS and DPH are committed to moving the needle forward and improving the quality of life for those facing this difficult disease.”

Delaware ranked highly in percentage of women at least 40 years of age who had a mammogram within the past two years and percentage of residents age 50 or older who received a sigmoidoscopy or colonoscopy.

Lung cancer, often caused by smoking, remains an issue. It is the most common cancer both nationwide and in Delaware, and it accounted for 30 percent of all deaths from cancer from 2009-2013.

Cigarette smoking prevalence among Delaware adults was at an all-time low of 20 percent, according to the 2014 Behavioral Risk Factor Survey, but the rate has remained static over the past four years.

Electronic cigarette use among high schoolers, meanwhile, rose from 2.1 percent in 2012 to 23.5 percent in 2015.

Delaware banned the sale of e-cigarettes to minors in 2014 and prohibited electronic cigarette usage indoors in one year later.

DPH’s Screening for Life Program covers lung cancer screenings for uninsured or underinsured Delawareans who are not eligible for Medicaid or Delaware’s Health Insurance Marketplace and are at a high risk for lung cancer.

To view Cancer Incidence and Mortality in Delaware, 2009-2013 and the 2016 Analysis of Delaware’s Census Tracts with Elevated Overall Cancer Rates in 2009-2013, visit DPH’s Cancer Prevention and Control Program website at http://www.dhss.delaware.gov/dhss/dph/dpc/cancer.html.