Cancer Cluster Mysteries Need Focused Research
By: Reuters
The New York Times, June 6, 2001
WASHINGTON (Reuters Health) - Federal and academic investigators
who hunt the elusive causes of cancer clusters across the country told
lawmakers Tuesday that researchers need better coordination of health data
collection in counties and states in order accomplish their mission.
While most cancer clusters can be blamed on smoking, poor diet, and other
lifestyle factors, the public remains concerned that elevated cancer rates
in their communities could come from pollution in the air, water and soil.
Recent movies depicting environmental pollution and a link to
cancer--including the hit ''Erin Brockovich''--have helped stoke public
fears.
Still researchers remain hampered by information collection that relies on
many different levels of government. States may keep data on cancer
incidence, but information on local levels of possible carcinogens is
often collected by counties, towns, or sometimes not at all, said Dr.
Robert N. Hoover, the director of epidemiology at the National Cancer
Institute.
Also, few data registries include information on how long community
residents have lived at their addresses. Such information is critical for
determining the length of possible chemical exposures.
Epidemiologists want better data coordination ``so we know everything that
goes on in a particular area,'' Hoover told members of the Senate Cancer
Coalition.
Federal agencies like the Centers for Disease Control and Prevention (CDC)
play a role in helping to coordinate a national cancer registry, but much
of the reporting relies on state systems that can vary widely.Consistent
cancer reporting and environmental monitoring is especially difficult in
rural areas, said Dr. Sue-Min Lai, an associate professor of preventive
medicine at the University of Kansas.
Scientists are ``excited,'' Hoover noted, about a pilot project in Long
Island, New York that is looking at ways to make studies easier by
improving the efficiency and compatibility of cancer statistics and
environmental data.
``The faster we could acquire the high-quality data and then analyze it,
the more answers we'd find,'' said Sen. Hillary Rodham Clinton (D-N.Y.).
Clinton announced that the Senate Environment and
Public Works Committee would hold hearings on Long Island next week
looking into reported elevated breast cancer rates there.
But giving researchers more access to health information raises concerns
about protecting the patients' privacy. Recent debates in Washington, DC
over the federal privacy protections for medical records have shown that
scientists' wish to have as much data as possible often clashes with
consumer groups' desire to protect privacy.
Dr. David W. Fleming, CDC's deputy director for science and public health
pointed to maps on display at the hearing depicting increased rates of
lung cancer among white men in the southeastern US and increased rates of
all cancers among women along the East and West coasts.
``There is a danger at times of crossing a bounds of privacy protection
where really it is difficult for researchers to generate this type of
information,'' Fleming said.
Sen. Dianne Feinstein (D-Calif.), who chairs the cancer coalition, is
looking to introduce legislation later this summer that would revise the
1971 National Cancer Act to fund efforts to improve data collection
surrounding cancer clusters, spokesman Jim Hock told Reuters Health.
Some researchers asked lawmakers and the public not to put undo stake in
cancer cluster investigations. Only 10% to 15% of 1,900 possible cancer
clusters reported to federal and state officials in 1996 even showed
actual increased cancer rates in specific areas. Only one study in history
has definitively linked a cancer cluster to an environmental pollutant in
a community, though others have linked occupational exposures to cancers
in workers.
``That's all we've ever found in the thousands of cluster studies that
have been done,'' said Dr. William Wright, the chief of cancer
surveillance at the California Department of Health Services.
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