NDCA

12/11/2007

Cancer not linked to pollution

Expert: Environment not a factor in elevated area cancer rates

BY JAMES LOEWENSTEIN
STAFF WRITER

While Towanda’s zip code has a cancer occurrence rate that is higher than the state rate, scientific research on cancer does not support the idea that the elevated rate is due to pollution in the environment, a state public health official said.

“There is nothing about the cancer rates (in the Towanda area) that suggests that environmental pollution is contributing to the rates,” said Gene Weinberg, director of the Division of Community Epidemiology at the Pennsylvania Department of Public Health.

Weinberg said he had been studying the cancer rates in the Towanda area during the past two weeks. He said he was prompted to undertake the study after The Daily Review quoted an environmental activist on Nov. 8 as stating that the cancer rate in Towanda’s zip code is significantly higher than the state rate. The activist, Towanda resident Diane Siegmund, was among a group of citizens who expressed concerns at the Nov. 8 meeting of the Bradford County commissioners that pollution from industrial plants and sites in the Towanda area is causing cancer and other health problems.

While the combined cancer rate in Towanda’s zip code, which is the total number of cancer cases per year, is approximately 20 percent higher than the state rate, that is not an unusual phenomenon, Weinberg said.

“We see variations of 20 percent all the time” from the state rate, he said.

“I don’t really see a reason, based on the numbers (cancer rates) that should generate any extra concern about cancer” in Towanda’s zip code, he said. However, there are steps that local residents can take to address their cancer risk, such as getting screenings for cancer and making lifestyle changes, he said.

Weinberg said there were limitations to his analysis of the cancer rates in the Towanda area, because he did not have specific information about the types of pollutants that people might have been exposed to, nor their level of exposure.

However, Weinberg did make a number of statements about cancer in the Towanda area, based on information such as the numbers of cases reported for all the different types of cancer, and the risk factors for those types of cancer.

Weinberg, who has a Ph.D. in epidemiology, said that he looked at the cancer rates in Towanda’s zip code — 18848 — and in six zip codes that border Towanda’s zip code, namely Monroeton, East Smithfield, Ulster, Troy, Wysox, and Sugar Run.

Weinberg said he looked at cancer data from the years 1996 through 2004, saying that examining nine years’ worth of data gives his study more validity.

“It (the study) is adequate enough,” Weinberg said. “If something is unusual, then it will stand out.”

The combined cancer rate for Towanda’s zip code is a composite rate that takes into account the cancer rates for every specific kind of cancer, Weinberg said.

If the combined cancer rate in a zip code is high, it is because there are elevated rates for one or more specific types of cancer within the zip code, he said.

However, there are only three types of cancer that stand out as elevated in the Towanda zip code, and the risk factors for those cancers “do not appear to be at all related” to environmental pollution that one would normally encounter in daily life such as, for example, pollution in the air outdoors or in drinking water, he said.

The three types of cancer that are elevated in Towanda’s zip code are prostate cancer, male urinary bladder cancer, and melanoma of the skin, Weinberg said.

“These three cancer rates appear a little higher than what we would expect through normal variation (in cancer rates), but the risk factors for those cancers do not appear at all related to the ambient environment,” he said. The ambient environment is the environment that citizens would encounter in their daily routines, such as the air they breathe outdoors and the water they drink, he said.

Other than the three elevated types of cancer, the cancer rates for all of the other types of cancer in Towanda’s zip code “don’t vary significantly from the statewide rates” for those cancers, Weinberg said.

The primary risk factor for melanoma of the skin is exposure to sunlight and ultraviolet radiation, as well as certain pre-existing skin conditions, such as freckles, Weinberg said.

The main risk factor for male urinary blader cancer is smoking, which causes 40 percent of the cases, Weinberg said. The second most important risk factor for male urinary bladder cancer is exposure to certain chemicals on the job, he said. However, the exposure to the chemicals would have had to have been in a work setting, and not from one’s general, ambient environment, he said.

Prostate cancer rates “can vary tremendously” from one community to another depending on the amount of screening that is done for the disease, Weinberg. An active screening program will turn up more men who have the disease, many of whom do not show symptoms, he said. Also, communities that have a larger-than-normal population of older men may have a higher rate of prostate cancer, since it is basically a disease of older men, he said.

“The scientific literature (scientific research) at this time does not support the idea that the ambient environment is causing the variation in the cancer rate that we see between the community of Towanda and the statewide rate,” Weinberg said.

After Siegmund and the other citizens expressed their concerns at the Nov. 8 meeting, the Bradford County commissioners agreed to form a county-wide task force that would look into environmental problems that may be affecting the health of local citizens.

At the Nov. 8 meeting, Siegmund displayed a map that showed the cancer rates in the zip codes in Bradford County and several neighboring counties.

The map was created by the Pennsylvania Department of Health, said Gregory Bogdan, an epidemiologist with the Department of Public Health.

The map shows that three zip codes in Bradford County have cancer rates that are significantly higher than the state rate: the Milan zip code, the Rome zip code and the Towanda zip code.

While the cancer rate in Towanda’s zip code is relatively high, it is not unusual, Bogdan said.

“There is not a pattern of elevated cancer rates (a large number of elevated rates for individual types of cancer) in this community (Towanda’s zip code),” Bogdan said. “In general, it (the picture of cancer rates in Towanda’s zip code) is pretty normal compared to the state average.”

“It is normal to see variations in cancer rates (among zip codes),” Bogdan said. “Some will be high and some will be low. And if you look at enough (zip codes), you will see some that are significantly high. That’s the way the data distributes itself.”

James Loewenstein can be reached at (570) 265-1633; or e-mail: jloewenstein@thedailyreview.com.

12/11/2007

PV report requires further review

BY SHAWN A. HESSINGER
STAFF WRITER
shessinger@republicanherald.com

Reaction from a federal agency has experts researching a local blood cancer looking for backup.

Dr. Paul Roda, an oncologist at Geisinger Hazleton Cancer Center/Geisinger Northeast Pennsylvania, said a presentation on local numbers of polycythemia vera, a cancer characterized by an elevated red blood cell count, was made Monday at a national convention in in Atlanta, Ga.

However, Roda, who attended the annual meeting of the American Society of Hematology, said the next step would likely be for Dr. Ronald Hoffman of the Mount Sinai School of Medicine in New York to recruit another specialist to review the findings.

“The sense of the presentation was that there is an elevated level but that he needs to bring in an epidemiologist to make a determination,” said Roda, who co-authored the report.

On Oct. 24, Hoffman, a national expert on polycythemia vera, made a presentation in Hazleton confirming 38 cases of the disease in eastern Schuylkill and northern Luzerne counties where statistically only 25 might have been expected - 52 percent higher than anticipated - over the last five years.

An abstract for the report posted on the Internet prior to the meeting seemed to reverse an earlier insistence by the Agency of Toxic Substances and Disease Registry that the study had found no links between the incidence of the disease and environmental exposure.

The abstract for the meeting revealed that 18 of the 38 cases confirmed by blood tests for a tell-tale genetic indication lived within 13 miles of a former Kline Township Superfund site.

McAdoo Associates was licensed as a metal reclamation and incineration facility on an 8-acre former mining site but was placed on the Environmental Protection Agency’s Superfund National Priorities List of most contaminated sites after community and environmental leaders say a variety of volatile organic chemicals and other wastes were dumped there.

After a federally mandated cleanup of the site, including removal of contaminated soil and 7,000 drums of chemicals in the early 1980s, the property was removed from Superfund status in 2001.

However, in another about face Friday, Agency of Toxic Substances and Disease Registry officials insisted the abstract had incorrectly characterized residents living within a 13-mile radius of McAdoo Associates between 1975 and 1990 during the site’s operation and cleanup as having had a 4½ times greater chance of developing the disease.

On Friday, federal officials insisted researchers may have injected bias into the study by failing to consider that many diagnosed with the disease also lived in different places away from the former Superfund site over that period.

“I can’t argue with that. All I can tell you is the longer you are in the area the more chance you have of developing the disease,” Roda added.

On Friday, Hoffman told the Associated Press he still considered evidence to point to an environmental factor for the elevated disease rate.

“Based upon the data, there’s significant concern that there is something in the environment leading to the development of polycythemia vera in the area. The nature of what’s causing it is unknown at the moment and is going to require further study,” he said.

After federal and state health officials raised concerns over the statistical evaluation of the 18 cases found within proximity to the Superfund site, Roda said, researchers will now seek input from an independent epidemiologist to prove suspicions that a cancer cluster, a statistically significant amount of the disease, is present.

“We still believe there’s a cluster. We believe in our science,” Roda said.

He added that the study had also revealed the importance of genetic testing to distinguish the disease from a secondary condition generally associated with cigarette smoking and Black Lung disease.

Officials at the Agency of Toxic Substances and Disease Registry could not be reached for comment on the report Monday.