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The cancer cluster concerns meeting will be held MONDAY, October 4 at 6:30pm in the first floor hearing room of Winchester Hall located at 12 East Church Street, Frederick, MD

http://www.frederickcountymd.gov/documents/Health%20Department/Press%20Releases/2010/Cancer%20Concern%20Community%20Mtg%2010%204%2010.pdf

 

Background

* The Maryland Department of Health and Mental Hygiene in collaboration with the Frederick County Health Department is conducting a preliminary statistical analysis of the cancer case data in the Maryland Cancer Registry.
* Objective: Determine if the rate of all cancers and/or certain types of cancer is higher than expected and what the likelihood is that an increase in cancer rates could be due to something other than chance alone in what is approximately a one-mile radius from Ft. Detrick.


Investigative Steps
The following investigative steps are taken when conducting a cancer cluster investigation- see Questions and Answers about Cancer Clusters (DHMH) for more details.

Step 1- Initial Information

* The process established by the Maryland Department of Health and Mental Hygiene to evaluate cancer cluster concerns begins with the local health department evaluating information about each cancer case thought to be part of a cluster.  
* The information needed includes specific information from concerned individuals about the types of cancers, the names and ages of persons diagnosed with those cancers, the dates of diagnosis, and the time period that persons diagnosed with cancer were in the geographic or occupational area of interest.
* This step was bypassed in the current investigation of concerns raised by residents living near Fort Detrick as there was enough information provided informally to the Frederick County Health Department by residents, and there is the possibility that specific case information collected by an external organization will be provided in the future.


Step 2- Preliminary Investigation

* This step is currently underway.  See details below related to the investigation.  Results are anticipated to be available November 2010.


Step 3- Further Investigation

* This step will be guided by the findings from the Step 2 preliminary investigation.



Sources of Data

* By law, hospitals, laboratories, cancer treatment centers, and doctors are required to report all new cancer cases diagnosed in Maryland (excluding basal and squamous cell skin cancer) to the Maryland Cancer Registry (MCR) of the Department of Health and Mental Hygiene.
* The MCR records the home address at the time of diagnosis of cancer.  The home address is then associated with a census tract number since the year 2000.  Before the year 2000, only zip code level groupings of the data are possible.
*

The initial analysis of data in the MCR will evaluate cancer cases that occurred in the geographic area of analysis based upon census tract level data available for the years 2000-2008.  The next analysis of the data in the MCR will be based on zip code level data going back to 1996.  Additional time periods of analysis will be guided by the findings from the first two time periods examined.


Geographic Area of Analysis

* The initial geographic area defined for the preliminary statistical analysis of cancer rates is roughly a one mile radius from Fort Detrick, Area A and Area B.
o Map of the Preliminary Area of Analysis
* In some cases the census tracts are more than a mile from the perimeter or fence line and in some cases little less than a mile.
* The one mile area was selected following discussions with cancer data experts and Randy White and his consultants.
* Analyzing too large of an area may “dilute” findings and too small of an area may not have enough numbers to determine if differences are statistically significant.


Types of Cancer in Analysis

* The types of cancer to be evaluated are based upon the off-site well contaminants documented.
* Two chemicals detected on off-site wells, tetrachloroethene (PCE) and trichloroethene (TCE), have been associated with cancer of the brain, leukemia, lymphoma, and kidney cancer.
* Due to concerns expressed about exposure to dioxin, liver cancer rates will also be evaluated.
* Additionally, based upon the number of thyroid cases reported at the August 12 Community Meeting, which were more numerous than what might be expected relative to the other cancers reported at the meeting, thyroid cancer was also added to the list of specific cancers being examined.
* These specific cancers will be evaluated in Step 2 of the investigation.
* The rates for the state of the four most common cancers (lung, breast, colorectal, and prostate) and the specific cancers of concern listed above will be compared to Frederick County rates and the rates in the smaller geographic area under investigation.   


Possible Next Steps

* If there is an increase in observed cases over the expected rate, the suspected cluster is tested to see if it is “statistically significant.”  This is a way of measuring how likely the increase is due to chance.
* Depending on how statistically significant the suspected cluster is, the investigation may be completed and a report generated or the situation may continue to be monitored into the future.
* If cancer data from the Maryland Cancer Registry show that the number of reported cases in an area is statistically significantly increased, then steps may be needed to better define the possible cluster and known risk factors.

http://www.frederickcountymd.gov/index.aspx?NID=4230

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