Frequently Asked Questions about ZIP Code cancer data

What do the ZIP Code lists show?

The ZIP Code lists show the number of people who developed the specific type of cancer while living in the ZIP Code area between 2005 and 2009. The lists also show the number of people who might have been expected to get cancer in that time period, based on the size of the population of the ZIP Code.

How do you find out how many people have cancer? How is the information on cancer incidence collected?

Under the New York State Public Health Law, all individuals diagnosed with cancer in New York State must be reported to the New York State Cancer Registry. The Cancer Registry routinely audits hospitals, laboratories and other health care providers to ensure that all required reports are made. The Cancer Registry also has reporting agreements with most other states, including all of the states that border New York. Through these agreements, New York State residents who are diagnosed at hospitals or by health care providers in other states are also reported to the Cancer Registry. The North American Association of Central Cancer Registries has recognized the New York State Cancer Registry as meeting the highest standard for completeness of reporting.

What is "expected incidence"?

Some ZIP Codes have a lot of people living in them; others have fewer people. Because of this, we cannot just compare the number of people diagnosed with cancer in each ZIP Code. Generally speaking, ZIP Codes with more people living in them will have more people with cancer. Those with fewer people will have fewer people with cancer. Also, because cancer is more common in older people, the age of the people who live in a ZIP Code is important. ZIP Codes where older people live will have more cancer than neighborhoods where younger people live.

Expected incidence is the number of people in a given ZIP Code that would be expected to develop cancer within a five-year period if the ZIP Code had the same rate of cancer as the State as a whole. The cancer rate for the entire state and the number of people in a ZIP Code are used to estimate the expected incidence. Age and population size are also taken into account because you would expect to see more people develop cancer in a ZIP Code with a larger population or a higher percentage of older residents. This process is called age adjustment.

How did you determine that a ZIP Code was higher, lower or about the same as expected?

The actual number of people who are diagnosed with cancer in the ZIP Code is compared to the expected number. For example, if there are 11 people diagnosed with cancer in a ZIP Code and, based on the population size of the ZIP Code, we would have expected only five cancers, the ZIP Code will be labeled as being more than 100% above expected.

What are "included ZIP Codes"?

Some ZIP Codes had too few cases to be shown for confidentiality reasons. These ZIP Codes are combined with neighboring ZIP Codes. Also, some ZIP Codes, such as ZIP Codes with only PO Boxes, are combined with the larger surrounding ZIP Codes. In the index, these ZIP Codes are listed with the ZIP Code with which they were combined. The numerical values given are for the combined group of ZIP Codes.

Why do the ZIP Code lists only go through 2009?

The information used to produce the ZIP Code lists is the most recent data available from the New York State Cancer Registry. Reporting to the Cancer Registry comes from hospitals, physicians, managed care organizations, laboratories, and other health care providers. Generally an individual is not reported to the Cancer Registry until they are discharged from the hospital. Under State law, the hospital or other health care provider has 180 days after diagnosis to report to the Cancer Registry. The North American Association of Central Cancer Registries has recognized the New York State Cancer Registry as meeting the highest standard for the timeliness of reporting.

Are the ZIP Code lists based on where a person lives (place of residence) or the hospital where they were diagnosed?

The ZIP Code lists are based on where the person lived at the time they were first diagnosed with cancer.

Why don't you provide more exact data about where people with cancer live?

By law, New York State must keep information about individuals with cancer confidential. To protect their privacy, we cannot show on a map where each person with cancer lives.

How do you know what ZIP Code a person lives in?

Information about where a person lives when they are diagnosed with cancer is usually collected from the persons' medical record. Hospitals and other medical facilities report this information to the cancer registry. Staff at the cancer registry also review the address information for completeness.

Does my chance of getting cancer increase because I live in a ZIP Code that has a higher incidence of cancer?

No. Just because you live or lived in a county or ZIP Code that has a higher incidence of cancer, you are not more likely to get cancer than someone who lives or lived in an area of lower incidence. Cancer risk depends on many things, including your lifestyle (smoking, diet), family history, and contact with cancer causing substances (sunlight, x-rays, tobacco smoke, some chemicals).

If I live in a ZIP Code that has a higher incidence of cancer, what is causing the increase? Is the environment to blame?

The cancer incidence data provided here cannot tell us that something in the environment causes cancer. Most cancers develop slowly in people. They usually appear five to 40 years after exposure to a cancer causing substance. This is called the latency period. Latency is one of the reasons it is difficult to determine what causes cancer in humans. Also, many people move several times during their life making it difficult to link exposures to cancer causing substances to where a person lives.

I am concerned that more people in my community have cancer than is usual. Where can I go for help?

The Cancer Surveillance Program in the New York State Department of Health's Center for Community Health responds to citizen concerns over cancer in communities. Over the years, we have come to realize that many people become concerned when they see a number of people being diagnosed with cancer because they are not aware of how common a disease cancer is, or that people are more likely to develop cancer as they grow older. It is also important to realize that cancer is not a single disease, but a collection of over 100 different diseases, each with its own risk factors. Of course, it is also possible that what a citizen is seeing may be an unusual occurrence of cancer, and so it is important to follow up on these reports.

If you are interested in speaking with someone from the Cancer Surveillance Program to discuss your concerns in detail, please send an e-mail to the link below. Please include in your e-mail a telephone number at which you may be reached during the day.

Are you going to provide data for other types of cancer? How about for children with cancer?

We have provided ZIP Code data for the four most common types of cancer. Together, these cancers make up over half of all the cancers among New Yorkers. We cannot provide ZIP Code data for rare types of cancer for confidentiality reasons. For example, childhood cancer is so rare even the larger ZIP Code areas will have no more than one or two children with cancer. Data on other types of cancer, including childhood cancer, is available for counties from the New York State Cancer Registry web site.