Characteristics of Cancer Patients in the World Trade Center Environmental Health Center

et al. 2021

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(1) Background: Recent studies have reported elevated risks of multiple cancers in the World Trade Center (WTC) affected community members (also called WTC “Survivors”). The large variety of WTC-cancers created a need to develop a comprehensive cancer database. This paper describes the development of a pan-cancer database at the WTC Environmental Health Center (EHC) Data Center. (2) Methods: A new REDCap-based pan-cancer database was created using the pathology reports and available biomarker data of confirmed cancer cases after review by a cancer epidemiologist, a pathologist, physicians and biostatisticians. (3) Results: The WTC EHC pan-cancer database contains cancer characteristics and emerging biomarker information for cancers of individuals enrolled in the WTC EHC and diagnosed after 11 September 2001 and up to 31 December 2019 obtained from WTC EHC clinical records, pathological reports and state cancer registries. As of 31 December 2019, the database included 3440 cancer cases with cancer characteristics and biomarker information. (4) Conclusions: This evolving database represents an important resource for the scientific community facilitating future research about the etiology, heterogeneity, characteristics and outcomes of cancers and comorbid mental health conditions, cancer economics and gene–environment interaction in the unique population of WTC survivors.

Section: Resultsmentioning

confidence: 99%

The Development of a WTC Environmental Health Center Pan-Cancer Database

Shao

et al. 2021

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“…Fifteen patients had more than one primary lung cancer diagnosis. Lung cancer was the second most frequent cancer (after breast cancer) in women accounting for 11% of female cancers, whereas it was the third most frequent cancer (after prostate cancer and lymphomas) in men, accounting for 7% of all male cancers patients in the WTC EHC population [ 34 ].…”

Section: Resultsmentioning

confidence: 99%

“…Previously, we described overall cancer characteristics in the WTC EHC [ 34 ]. Lung cancer is the third most frequent cancer in our community population (9%) and the second most frequent cancer in women (11%).…”

Section: Introductionmentioning

confidence: 99%

Lung Cancer Characteristics in the World Trade Center Environmental Health Center

Pehlivan

et al. 2021

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The destruction of the World Trade Center (WTC) towers on 11 September 2001 resulted in acute and chronic dust and fume exposures to community members, including local workers and residents, with well-described aerodigestive adverse health effects. This study aimed to characterize lung cancer in the WTC Environmental Health Center (WTC EHC) focusing on gender and smoking history. WTC EHC patients undergo an initial evaluation that includes WTC exposure information, demographics, and tobacco use. Detailed cancer characteristics are recorded from pathology reports. As of 31 December 2019, 248 WTC EHC patients had a diagnosis of lung cancer. More patients with lung cancer were women (57%) compared to men (43%). Many cases (47% women, 51% men) reported acute dust cloud exposure. Thirty-seven percent of lung cancer cases with available smoking history were never-smokers (≤1 pack-years) and 42% had a ≤5 pack-year history. The median age of cancer diagnosis in never-smoking women was 61 years compared to 66 years in men. Adenocarcinoma was more common in never-smokers compared to ever-smokers (72% vs. 65%) and in women compared to men (70% vs. 65%). We provide an initial description of lung cancers in local community members with documented exposure to the WTC dust and fumes.

“…Among them, 2840 persons were diagnosed with any type of cancer, including 601 patients with a primary breast cancer diagnosis (592 women, 9 men). Breast cancer is the most frequent cancer among women in the WTC EHC, accounting for 46% of all female cancer diagnoses [ 17 ]. Among 592 female patients with breast cancer, 41 women had two primary breast cancer diagnoses resulting in a total of 633 (512 invasive and 121 in situ) female breast cancer diagnoses.…”

Section: Resultsmentioning

confidence: 99%

“…Community members self-refer into this program and under law inclusion requires the presence of a “certifiable condition” linked to the WTC disaster [ 15 ]. As of 31 December 2019, 11,048 individuals were enrolled in the WTC EHC program, with 2840 individuals diagnosed with cancer [ 17 ]. Of them, 592 women and 9 men were diagnosed with breast cancer.…”

Section: Methodsmentioning

confidence: 99%

Breast Cancer Characteristics in the Population of Survivors Participating in the World Trade Center Environmental Health Center Program 2002–2019

Arslan

et al. 2021

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The destruction of World Trade Center on 11 September 2001 exposed local community members to a complex mixture of known carcinogens and potentially carcinogenic substances. To date, breast cancer has not been characterized in detail in the WTC-exposed civilian populations. The cancer characteristics of breast cancer patients were derived from the newly developed Pan-Cancer Database at the WTC Environmental Health Center (WTC EHC). We used the Surveillance, Epidemiology, and End Results (SEER) Program breast cancer data as a reference source. Between May 2002 and 31 December 2019, 2840 persons were diagnosed with any type of cancer at the WTC EHC, including 601 patients with a primary breast cancer diagnosis (592 women and 9 men). There was a higher proportion of grade 3 (poorly differentiated) tumors (34%) among the WTC EHC female breast cancers compared to that of the SEER-18 data (25%). Compared to that of the SEER data, female breast cancers in the WTC EHC had a lower proportion of luminal A (88% and 65%, respectively), higher proportion of luminal B (13% and 15%, respectively), and HER-2-enriched (5.5% and 7%, respectively) subtypes. These findings suggest considerable differences in the breast cancer characteristics and distribution of breast cancer intrinsic subtypes in the WTC-exposed civilian population compared to that of the general population. This is important because of the known effect of molecular subtypes on breast cancer prognosis.