Response to Condon et al. comments on “Cancer clusters in the USA: What do the last twenty years of state and federal investigations tell us?”

Goodman, Michael; Naiman, Joshua S.; Goodman, Dina; LaKind, Judy S.

doi:10.3109/10408444.2012.743505

Cited by 4 publications

(2 citation statements)

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“…Many clusters reported to the public health agencies by concerned citizens are accompanied by an expectation that an investigation will uncover a specific environmental cause of disease in the affected community [ 3 , 30 , 37 , 46 ]. By this measure, with few exceptions, cancer cluster investigations have not been successful [ 8 ].…”

Section: What Is a Cancer Cluster And What Are The Goals Of Investmentioning

confidence: 99%

“…While goals, methods and conclusions of cluster studies are debated in both the scientific literature [ 8 , 25 , 29 , 30 , 31 ] and the popular press [ 32 , 33 , 34 , 35 ], investigations of reported residential clusters rarely provide definitive answers about disease etiology [ 8 , 36 , 37 , 38 , 39 , 40 ]. Further, it is inherently difficult to study a cluster for a disease with complex etiology and long latency such as most cancers.…”

Section: Introductionmentioning

confidence: 99%

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Cancer Cluster Investigations: Review of the Past and Proposals for the Future

Goodman

LaKind

Fagliano

et al. 2014

IJERPH

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Residential clusters of non-communicable diseases are a source of enduring public concern, and at times, controversy. Many clusters reported to public health agencies by concerned citizens are accompanied by expectations that investigations will uncover a cause of disease. While goals, methods and conclusions of cluster studies are debated in the scientific literature and popular press, investigations of reported residential clusters rarely provide definitive answers about disease etiology. Further, it is inherently difficult to study a cluster for diseases with complex etiology and long latency (e.g., most cancers). Regardless, cluster investigations remain an important function of local, state and federal public health agencies. Challenges limiting the ability of cluster investigations to uncover causes for disease include the need to consider long latency, low statistical power of most analyses, uncertain definitions of cluster boundaries and population of interest, and in- and out-migration. A multi-disciplinary Workshop was held to discuss innovative and/or under-explored approaches to investigate cancer clusters. Several potentially fruitful paths forward are described, including modern methods of reconstructing residential history, improved approaches to analyzing spatial data, improved utilization of electronic data sources, advances using biomarkers of carcinogenesis, novel concepts for grouping cases, investigations of infectious etiology of cancer, and “omics” approaches.

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Section: What Is a Cancer Cluster And What Are The Goals Of Investmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cancer Cluster Investigations: Review of the Past and Proposals for the Future

Goodman

LaKind

Fagliano

et al. 2014

IJERPH

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Krebsregister und Gesundheitswesen

2017

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Residential cancer cluster investigation nearby a Superfund Study Area with trichloroethylene contamination

Press

McKinley

Deapen

et al. 2016

Cancer Causes Control

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Purpose Trichloroethylene (TCE) is an industrial solvent associated with liver cancer, kidney cancer, and non- Hodgkin’s lymphoma (NHL). It is unclear whether an excess of TCE-associated cancers have occurred surrounding the Middlefield–Ellis–Whisman Superfund site in Mountain View, California. We conducted a population- based cancer cluster investigation comparing the incidence of NHL, liver, and kidney cancers in the neighborhood of interest to the incidence among residents in the surrounding four-county region. Methods Case counts and address information were obtained using routinely collected data from the Greater Bay Area Cancer Registry, part of the Surveillance, Epidemiology, and End Results program. Population denominators were obtained from the 1990, 2000, and 2010 US censuses. Standardized incidence ratios (SIRs) with two- sided 99 % confidence intervals (CIs) were calculated for time intervals surrounding the US Censuses. Results There were no statistically significant differences between the neighborhood of interest and the larger region for cancers of the liver or kidney. A statistically significant elevation was observed for NHL during one of the three time periods evaluated (1996–2005: SIR = 1.8, 99 % CI 1.1–2.8). No statistically significant NHL elevation existed in the earlier 1988–1995 (SIR = 1.3, 99 % CI 0.5–2.6) or later 2006–2011 (SIR = 1.3, 99 % CI 0.6–2.4) periods. Conclusion There is no evidence of an increased incidence of liver or kidney cancer, and there is a lack of evidence of a consistent, sustained, or more recent elevation in NHL occurrence in this neighborhood. This evaluation included existing cancer registry data, which cannot speak to specific exposures incurred by past or current residents of this neighborhood.

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Response to Condon et al. comments on “Cancer clusters in the USA: What do the last twenty years of state and federal investigations tell us?”

Cited by 4 publications

References 10 publications

Cancer Cluster Investigations: Review of the Past and Proposals for the Future

Cancer Cluster Investigations: Review of the Past and Proposals for the Future

Krebsregister und Gesundheitswesen

Residential cancer cluster investigation nearby a Superfund Study Area with trichloroethylene contamination

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