PORTLAND – Maine stacks up poorly in a new report on 34 states’ efforts to spot cancer trends and track the deadly disease.

Trust for America’s Health, a Washington, D.C.-based health advocacy group, ranked Maine near the bottom of the states that participated in the study.

The group gave Maine a “D” grade for its cancer registry, along with North Dakota and Tennessee. Mississippi was the only state that received an “F.”

Twelve states, including Massachusetts, received an “A.”

State officials say the report relies on outdated data. They say Maine’s cancer registry has improved considerably through the hard work of a small staff in recent years.

But the report’s authors argue that lives could be saved if Maine did a better job of collecting statistics, comparing cancer cases with occupational, lifestyle and environmental information, and targeting cancer prevention efforts.

Last year, cancer killed about 3,000 Mainers and cost the state $935 million, according to the American Cancer Society.

The report says Maine should take the lead from states such as California, which identified a higher cancer rate among members of a largely Hispanic farmworker labor union.

“Maine has a significant problem here,” said Shelley Hearne, executive director of Trust for America’s Health.

“They need to make the investment to match up to the rest of the country and then take it farther.”

Maine’s 20-year-old cancer registry receives about $350,000 from the federal government and $75,000 from the state annually.

The report’s authors said Maine has not done as much as other states.

For example, Maine does not audit doctors’ offices and hospitals to make sure they thoroughly and accurately report cancer cases. And Maine’s annual report this year is based on statistics from 1997 to 1998.

State officials say Maine’s cancer registry is doing the best it can after years of understaffing, and that many positive changes are coming.

Maine studies cancer data looking for patterns involving age, county of residence, race and gender.

That helped the state in the 1990s identify the growing prevalence of breast cancer. It also helped the state seek federal funding for screening services for women who have little or no insurance coverage, officials say.

“We know the quality and completeness of the data is excellent,” said Castine Verrill, an epidemiologist for the cancer registry.

“It’s just the timeliness issue we’ve been trying to work on.”

Efficiency, she says, should improve once staffing increases.

With additional help, the registry expects to eliminate years’ worth of backlog over the next 12 months.

Reports including data up to 2002 also should be ready within that time period, Verrill says.