Cancer Cluster Investigationsin Andover, 2005-2011

GM Monawar Hosain

State Cancer EpidemiologistBureau of Public Health Statistics and Informatics

NH Division of Pubic Health Services

Cancer in NHCancer in NHCancer has been the #1 leading cause of death in New Hampshire since 2005

It is the cause of approximately 25% of all deaths in New Hampshire

Lifetime risk of developing cancer:1 in 2 male, 1 in 3 female

>75% of cancers occur after age 55 years

<1 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85 +

Both sexes

0.000750489158111984

0.00227827065855424

0.00152778150044225

0.00163499423731539

0.00302875981666622

0.00463695086976333

0.0066739928703

53

0.0105068482135

678

0.0181189525315

607

0.0336647993781

661

0.0560186550162

159

0.0896298480259

455

0.1137795170066

2

0.1337746924334

61

0.1327025650647

3

0.1193813825082

42

0.1120641132166

5

0.0875123964727

01

0.0723149910209

333

Female

0.000844547041270199

0.0022521254433

872

0.00135127526603232

0.00180170035470976

0.00258994425989528

0.00501097911153651

0.00743201396317775

0.0132875401159

845

0.0249422892855

132

0.0469568154946

23

0.0718991047801

363

0.0965035752491

414

0.1092280840042

79

0.1215584708068

24

0.1118180282641

74

0.1023591014019

48

0.1014019480885

09

0.0922245369067

057

0.0865379201621

531

Male

0.000665029670554533

0.00230202578268877

0.00168815224063843

0.00148352772662165

0.00342746060978105

0.00429711479435236

0.00598526703499079

0.00798035604665439

0.0119193779414

774

0.0215878862287

702

0.0415899324739

104

0.0833844894618

375

0.1179148762021

69

0.1448741559238

8

0.1516779210149

38

0.1348475547370

57

0.1217515858399

84

0.0832310210763

25

0.0593922651933

702

2%

6%

10%

14%

Age Group

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Age Distribution by Gender

NH is the 4th oldest in USAThis increased longevity may create the impression that cancer is becoming much more common even though an increase in the number of cancer cases is partly related to the aging populationMedian Age of NH: 41.1 + 0.1yearsMedian age of Andover: 48.6 + 2.6 years

Are we seeing more cancer cases?

Total number of invasive cancer cases in NH during 2005-2011 time period:N= 52,474

The total number invasive cancer cases in Andover during the same period:N= 96

(only Breast, Prostate, Lung, Colorectal, Melanoma and Uterus had 5 or more cases)

Cancer Facts

A cancer cluster is the occurrence of a greater than expected number of cases of a particular cancer

within a group of peoplewithin a geographic area, or within a period of time

Definition of a Cancer ClusterDefinition of a Cancer Cluster

A suspected cancer cluster is more likely to be a true cluster, if it involves:

A large number of cases of a similar type of cancer, rather than several different typesA rare type of cancer, rather than common types, andAn increased number of cases of a certain type of cancer in an age group that is not usually affected by that type of cancer

Analysis

The common occurrence of a cancer increases the potential for cancer cases to appear to cluster in a neighborhood.

This is why we conduct statistical analyses to see whether local cancer rate are within the normal range of variations

The standardized incidence ratio (SIR) is a measure that compares the cancer rate in a town with the state/country, taking into account differences in age in the different communities

Standard Incidence Ratio (SIR)

Findings

This report was prepared based on data from the NH State Cancer Registry, 2005-2011

Only invasive cancers were included:

Malignant cases (localized, regional, distant stage) of all cancer sites and

In-situ cancers of urinary bladder only

Gender Expected Observed SIR lower CL Upper CL

Male 54.8 62 1.13 0.87 1.45

Female 43.5 34 0.78 0.54 1.09

Both 96.7 96 0.99 0.80 1.21

All cancers

Gender Expected Observed SIR lower CL Upper CL

Female 13.1 12 0.91 0.47 1.60

Breast Cancer (Female)

Gender Expected Observed SIR lower CL Upper CL

Male 15.8 13 0.82 0.44 1.41

Prostate Cancer

Gender Expected Observed SIR lower CL Upper CL

Male 7.4 10 1.35 0.65 2.48Female 6.1 5 0.82 0.26 1.91

Both 13.3 15 1.13 0.63 1.86

Lung Cancer

Gender Expected Observed SIR lower CL Upper CL

Both 8.0 11 1.38 0.69 2.47

Colorectal Cancer

Gender Expected Observed SIR lower CL Upper CL

Both 5.1 6 1.17 0.43 2.55

Melanoma

Gender Expected Observed SIR lower CL Upper CL

Female 3.2 5 1.57 0.51 3.67

Uterus

ConclusionTime Period 2005- 2011

Our results suggest that various cancer rates are within the range of what is expected in comparable populations in New Hampshire

Statistical estimates are not exact, but these numbers do not look outside of the normal range of variability

These results are reassuring, as they suggest that the most likely explanation for these observations is random chance and not due to environmental factors

These analyses do not prove absolutely that there is no issue in your community, but the information does not lead us to believe there is a specific environmental concern causing cancer in your community

It is unfortunate when any adult or child develops cancer, regardless of data and statistics, and We appreciate that you brought it to our attention, and We will continue to monitor cancer rates in the future.

Any Questions??

Thank you.