Concerned About Cancer in Your Community?
The New York State Department of Health responds to concerns about cancer in communities. This webpage describes the approach taken and what to expect when contacting the Department of Health with concerns about cancer.
Over the years, many people concerned about cancer have contacted the Department of Health. Sometimes they were concerned about the number of people in their neighborhood, workplace or school who had cancer diagnoses. Other times people were worried about something in their local environment that might be affecting their health, or the health of their friends, family or neighbors. Also, some individuals were concerned because data from the Department of Health showed that cancer rates in their community were higher than those of neighboring communities or the rest of the state.
Examples of Concerns from the Public
- There seems to be a large number of people diagnosed with cancer in my neighborhood. Is this a cluster?
- I (or my friend, coworker or family member) was diagnosed with cancer. I am worried that something in the local community caused it.
- I live in an area where cancer incidence is high and I wonder if I should move.
- I am worried that contaminants from my workplace, an industrial site or a facility in my neighborhood might be causing cancer.
Many people are concerned that the number of cases of cancer in their area is unusual. In most cases, it is not; cancer is more common than many people realize. In fact, about 40% of people will be diagnosed with cancer during their lifetimes. Aging is the leading risk factor for developing cancer, so it is not uncommon to hear of people over 40 years old who have been diagnosed with cancer.
Sometimes people describe a situation where people in a neighborhood or location have different types of cancer (e.g., cancers affecting different parts of the body). Usually, this is not a cluster. Cancer is not a single disease; it is more than 100 different diseases. Each cancer type has its own risk factors and treatment. If people are being diagnosed with different kinds of cancers in a community, the cancers are probably unrelated.
About Cancer and Clusters
Scientists define a cancer cluster as a larger number of cancers than expected in a specific geographic area or in a specific group of people during a certain time period. Unusual patterns of cancer (clusters) do occur. Unfortunately, the amount of information that can be obtained about why a cluster might be occurring, or what might be causing it, is usually quite limited. Here are some reasons why:
- Cancer is not well understood by scientists. For the most part, scientists do not yet know why one person gets cancer while another person does not. The latest studies show that the causes of cancer likely have to do with complex interactions between genetics, lifestyles and exposures, which are difficult to track and measure.
- Most types of cancer take a long time to develop. It can take anywhere between 5 and 40 years between an exposure that may have caused the cancer and the onset of the disease. This time delay is referred to as cancer latency and it poses great challenges to identifying what causes cancer.
- People move around during their lifetimes and that information is difficult to track. The New York State Cancer Registry only records where a person lives at the time of his or her cancer diagnosis. When that residence information is shown on maps and other data displays, it may create an impression that something related to that location is causing the cancers. However, because of cancer latency, if a person were exposed to a contaminant that affected his or her risk it may not have occurred at that location. In fact, causes of cancer may have more to do with personal histories, genetics or lifestyles of the people who live in that area.
What to Expect
An in-depth conversation is the best way to obtain the information necessary to thoroughly understand a person's concern about cancer. A Department of Health staff member will respond to an inquiry, if possible, by telephone. During the telephone conversation, information about the specific cancer concern, details about individuals with cancer in the neighborhood, workplace or school, and any environmental concerns will be discussed. Information about the specific cancer(s) and risk factors will be provided, as well as information the Department of Health may have about cancer in the area of concern. Available information about any potential sources of environmental contamination will also be discussed.
This conversation will put cancer concerns into perspective, share what is known about the cancer(s) and provide a better understanding of how any environmental contaminants might affect people's health. It may also help satisfy the concern.
There are cases where additional steps, such as review or collection of more data, might be needed to learn more about cancer in a community, workplace or school. The factors below are considered before deciding if an investigation might be useful.
What is known about cancer in the community, workplace or school?
- Can the reported cancers be confirmed by the Cancer Registry?
- Are there any unusual patterns in the confirmed cancers that might be explained by data already available?
- Have the cancers of concern been associated in the scientific literature with any contaminants that might be present in the community?
Is there a common risk factor or exposure?
- Do the people who were diagnosed with a particular type of cancer share a common race or ethnicity, lifestyle practice, work environment or another factor that might be related to their cancer?
What is known about the community's exposures to environmental contaminants?
A substance cannot cause health effects without exposure (by touching the skin, being inhaled, or consumed in food or drink). Questions that may be explored include:
- Are there known or potential exposures to unusual environmental contaminants that may have affected or be affecting the community?
- If so, can information be obtained to help identify how much and for how long exposure took place?
Is this a situation that should or can be addressed by a public health action?
- Does the concern relate to something that may continue to affect people's health?
- Is there an action that can be taken to protect public health, such as informing people who may be at higher risk, promoting preventive health care, or coordinating with other agencies to report or evaluate an unusual environmental exposure?
Would an investigation contribute to the scientific knowledge of cancer?
- Would further investigation help to answer scientific questions that would apply to other situations or further what is known about that cancer?
Is follow-up possible?
- Can data of sufficient quality to learn more about possible exposures or risk factors be obtained?
- Are the expertise and resources needed for appropriate follow-up activities available, or, can recommendations be made for others to take actions to help the community?
Is there community interest and support?
- Are members of the community interested and willing to support follow-up activities?
About Cancer Investigations
Responses to cancer cluster concerns usually do not include cancer investigations or studies. The main reason for this is that the type of studies that can be done by a state health department, cancer incidence studies, cannot answer the questions people have about the causes of cancer. Cancer incidence studies determine whether cancer is being diagnosed more or less often than expected. They cannot answer why increased cancer incidence occurred.
One example of when a study may be useful is when there is specific information about unusual exposures to contaminants in homes, schools or workplaces. In these cases, the people affected may be very concerned about whether any specific types of cancer are occurring more frequently in their community and a cancer incidence study can address those questions.
To speak with someone from the Department of Health about cancer concerns, please send an e-mail to firstname.lastname@example.org. Please include a brief description of your concern, your name, and a daytime telephone number where you can be contacted. Also, you may call 1-518-473-7817 for concerns about cancer in communities or 1-518-402-7950 for concerns about cancer in the workplace or near an environmental site.