Health Department Releases Latest Cancer Maps

ZIP Code Level Maps Detail Colorectal And Lung Cancer Incidence

Albany, December 5, 2000 – State Health Commissioner Antonia C. Novello, M.D., M.P.H., Dr. P.H. today released ZIP Code level maps depicting the incidence of colorectal and lung cancer by ZIP Code across the State. These maps will be made available to the public on the Health Department's web site (www.health.state.ny.us). Dr. Novello also outlined a comprehensive protocol to investigate epidemiological and environmental risk factors that may contribute to unusual patterns of cancer.

Both the maps and disease investigation protocol are part of the State's $4 million Cancer Surveillance Improvement Initiative, introduced in 1998 by Governor George E. Pataki. This initiative is the most comprehensive statewide cancer–mapping project in the nation.

"This initiative demonstrates Governor Pataki's commitment to providing the people of New York State with useful information about where cancer is occurring in their communities," Dr. Novello said. "Because these maps suggest unusual patterns of cancer occurrence, they can help guide targeted research efforts that may reveal new information about the causes and risk factors for lung and colorectal cancer. Knowing more about these kinds of cancer will also prompt people to make health decisions that may prevent cancer or promote early detection."

The initiative includes the production of maps and other graphic representations that track the incidence of cancer, along with accompanying explanatory and health education materials. Its ultimate goal is to increase understanding of the causes and risk factors for cancer, and to promote prevention and early detection among New Yorkers. Previously, ZIP Code level breast cancer maps and county level maps detailing incidence of 11 types of cancer were released. Maps of cancer risk factors will be produced in future stages of the project.

The cancer maps released today were produced using data from the New York State Cancer Registry for the years 1993–1997. In addition to color–coding rates of lung and colorectal cancer by ZIP Code, the maps also indicate "areas of elevated incidence" designated by slanted and crossed lines on the maps.

Areas of elevated incidence are groups of ZIP Codes where lung and colorectal cancer incidence is higher than the State rate as a whole and the increase is least likely to be due to chance. These were determined using a statistical method called the spatial scan statistic that combines ZIP Codes to create statistical power and minimize the possibility that an excess in cancer incidence is a random occurrence.

An expert panel comprised of scientists, academicians, environmental advocates and cancer activists is advising the Department on the course of the Cancer Surveillance Improvement Initiative, including the development and production of the maps released today. Currently, the panel is exploring other mapping options, including mapping prostate cancer, as well as some cancer risk factors.

Lung and colorectal cancer were selected for mapping because they are among the most common cancers. Lung cancer is the number one cancer killer for both men and women in New York State. Each year, about 10,000 New Yorkers die from lung cancer.

Colorectal cancer is the third most frequently diagnosed type of cancer. This year, alone, more than 10,000 new cases of colorectal cancer will be diagnosed in New York State and nearly 6,000 New Yorkers will die from the disease. Colorectal cancer is often not diagnosed until the later stages, when it is less likely to respond to treatment. Routine screening can help detect colorectal cancer in early, more curable stages.

The ZIP Code level maps released today show areas of elevated incidence of lung cancer in northern New York State, among other locations. Sections of the Adirondack and Catskill mountain regions, in particular, show unusual patterns of colorectal cancer.

The primary risk factor for lung cancer is tobacco use. Exposure to indoor radon also can increase lung cancer risk. Because smoking is such a strong risk factor for lung cancer, it is difficult to see a correlation between areas of elevated incidence of lung cancer and previously released maps indicating high levels of indoor radon.

To combat smoking in New York State, under Governor Pataki, New York is implementing the most aggressive anti–smoking campaign in State history. The State has undertaken a comprehensive, $60 million statewide anti–smoking and tobacco control effort, which includes:

  • Support for school–based tobacco prevention programs;
  • Creation of the largest anti–tobacco advertising program in State history;
  • Promotion of smoking cessation services;
  • Support for a statewide tobacco quitline (1–888–609–6292);
  • Advertising aimed at adult smoking cessation;
  • Advertising to highlight the dangers of secondary smoke; and
  • Coverage of prescribed and over–the–counter smoking cessation products.

Governor Pataki also recently signed into law the nation's first Fire–Safe Cigarette Law. The new law requires all cigarettes sold in New York to be designed in a "fire–safe" manner that will prevent continuous burning when they are not smoked for a specified period of time. It also includes tough new enforcement provisions to help combat cigarette bootlegging.

Colorectal cancer may be associated with consumption of foods high in animal fat and lack of physical activity. To increase the chance that colorectal cancer will be detected early, most people should consider annual screening once they reach age 50. Those with a family history of the disease may benefit from earlier screening and should discuss options with their health care provider.

New York State currently supports 16 local colorectal cancer–screening projects across the state. These projects serve low income, uninsured or underinsured men and women age 50 and older in 28 counties. Over the past two years, the projects have provided over 23,000 men and women education about colorectal cancer and the opportunity for initial screening. It is anticipated that additional projects will be funded beginning in 2001.

Many things contribute to cancer risk including age, heredity, lifestyle factors, and exposure to cancer–causing agents. Maps alone cannot suggest reasons for an increased cancer incidence. However, the Health Department has developed a strategy to help scientists prioritize and carry out studies to investigate the epidemiological and environmental factors that may contribute to a pattern of disease. The comprehensive protocol is designed to:

  • Confirm that an unusual disease pattern exists and is not due to some artificial factor(s);
  • Evaluate sources of human exposure to environmental contamination;
  • Review risk factors for the disease under investigation; and
  • If exposure to an environmental factor is found and a study is feasible, perform additional research to determine whether the environmental factor may be associated with the disease pattern.

During the course of an investigation, scientists will evaluate information from a broad range of historical and current sources about the environment. Through a review and interpretation of the scientific literature, they will study substances that are known or suspected to contribute to the disease, as well as previously unexplored factors that have a potential role in disease development. This process will help to explore all known, suspected or possible environmental risk factors.

Dr. Novello also detailed what next steps the Health Department would be taking to further provide information to the public through the Cancer Surveillance Improvement Initiative. Those steps include:

  • a statewide screening day, including for breast cancer and colorectal cancer;
  • working with county health departments to formulate prevention and screening activities in their counties;
  • targeting state resources consistent with information developed through the mapping project;
  • continuing to work with the Department of Environmental Conservation on the issue of environmental risk factors;
  • preparing prostate ZIP Code level cancer maps; and
  • meeting with expert advisory panel.

Cancer maps are posted on the New York State Health Department's web site, (www.health.state.ny.us) along with information about the Cancer Surveillance Initiative; general facts about the 11 types of cancer that have been mapped to date; known and suspected causes of cancer; cancer prevention information and advice on how to read the maps and accompanying ZIP Code index.

Those who would like additional information also may call 1–800–458–1158 toll–free.

12/5/00–138 OPA