BOSTON -- Massachusetts is one of the deadliest states in the nation for teen drivers, according to a new survey done by a physicians group.

According to the third annual study, close to 20 percent of all traffic accident fatalities in the Bay State in 2005 involved at least one 16-to 20-year-old driver.

Massachusetts actually moved up to sixth place on the list from 26th place between 2004 and 2005, according to the study. In 2004, 20.17 percent of Massachusetts' 476 fatal traffic accidents involved teens, according to the study. In 2005, 19.23 percent of Massachusetts 442 traffic fatalities involved teens.

Delaware topped the most recent list, with 23.88 percent of its traffic fatalities involving teens. It was followed by Maine, Iowa, Wisconsin and Missouri. Vermont was seventh on the list behind Massachusetts.

The safest state was Alaska, at the bottom of the list with 9.72 percent of its traffic fatalities involving teens.

The overall data indicated that youth-related fatalities actually declined nationally but still represent a disproportionately high percentage of all traffic deaths.

"We are cautiously optimistic regarding the improvement in national youth-related driving fatalities from 2004 to 2005. However, the number of people dying in crashes involving young drivers has simply not decreased significantly in recent years," said Dr. Tom Esposito, Vice Chairman of the American College of Surgeons.

"In 1994, 21 percent of all people killed in traffic crashes died in a crash where at least one driver was age 16-20. In 2004, that percentage was 20 percent," Esposito said.

Nationally in 2005, 7,177 people died in youth-related traffic crashes, accounting for more than 16 percent of all traffic fatalities in the country.

"Graduated Driver Licensing (GDL) laws have been implemented by many states. Some are very good and some pretty weak, but, all told, the death toll is not changing much," Esposito said. "Over the last 10 years, young drivers have been involved in 20 percent of all fatal motor vehicle crashes, yet they comprise just 6 percent of the driving population and drive far fewer miles than adults."

The study, based on each the number of fatalities involving 16-to 20-year-old drivers as a percentage of each state's overall traffic fatalities, was conducted by the physician-led group End Needless Death on Our Roadways (END) and the Eastern Association for the Surgery of Trauma (EAST).

The groups called for implementation of a program that would stiffen requirements for all under-18 teen drivers. It would also require parental certification of 30 to 50 practice hours of behind-the-wheel training with an adult licensed driver, and six months with a learner's permit. The program also suggests no unsupervised nighttime driving for teens between 10 p.m. and 5 a.m.

"The solution to this crisis is multi-fold and includes GDL and primary belt safety laws, parent and teen education and strong enforcement," said Dr. Andrea Barthwell, co-chair of END.

"Our goal is to encourage states to find answers to the question of why a significant percentage of its total traffic fatalities involve 16 to 20 year old drivers -- an age group that makes up a very small percentage of the population. We must stop teens from killing and being killed," she said.