Table 1.
Summary of cancer cluster investigations by state.
| State | Cancer sites of concern: number of perceived clustersa | Confirmed clusters cancer site: Numberb | Hypothesized exposures: number of clusters | Link between cluster and hypothesized exposure |
|---|---|---|---|---|
| AL | NA | NA | NA | NA |
| AK | NA | NA | NA | NA |
| AR | NA | NA | NA | NA |
| AZ | Childhood leukemia:2, Brain:1 | Childhood leukemia:1 | Not listed:2, indoor air quality:1 | No |
| CA | Multiple sites:1, all childhood cancers:2, childhood leukemia and lymphoma:1, childhood hepatoblastoma:1, pancreas:1, lung:1, breast:1, cervix:1, bone:1, paranasal:1, melanoma:1, acute lymphocytic leukemia:1, acute myelocytic leukemia:1, chronic myelocytic leukemia:1, leukemia:1, brain:1, ovarian:1 | All childhood cancers:2, childhood leukemia and lymphoma:1, childhood hepatoblastoma:1, pancreatic cancer:1 | Not listed:3, chromium:1, VOCs:1, dioxins:1, ionizing radiation, including radon:3, EMF:1, PCBs:1, pesticides:1, unspecified water contamination:1 | No |
| CO | Multiple sites:2, brain:1 | Brain cancer:1 | Not specified:1, RF:1, PCE:1 | No |
| CT | Multiple sites:2, childhood cancers:2, childhood leukemia:1, colon:1 | None | Not listed:1, unspecified exposure from landfill and lagoon:1, VOCs:1 | No |
| DE | Multiple sites:11, all childhood cancers:1, all female cancers:1, brain:4, breast:3, thyroid:1, Hodgkin's disease:1, pancreas:1, lung:2 | All cancers:1, lung:1 | Not listed:16, unspecified water contamination:4, exposures from coal burning facility:1, unspecified exposures from nearby plant:1 | No |
| DC | NA | NA | NA | NA |
| FL | Multiple sites:1, brain:1 | None | Unspecified exposure from nearby farms and citrus groves:1, aluminum:1, antimony:1, arsenic:1, boron:1, cadmium:1, chromium:1, fluoride:1, iron:1, lead:1, lithium:1, manganese:1, mercury:1, nickel:1, selenium:1, thallium:1, vanadium:1, sulfate:1, gross alpha:1, radium-226:1, radon-222:1 | No |
| GA | Multiple sites:3, breast:1, glioblastoma multiforme:1, kidney and bladder:1 | None | Not listed:1, unspecified water contamination:1, unspecified exposures from nearby carpet manufacturing facility:1, EMF:1, VOCs:2, PCBs:1, lead:2, cadmium:1, barium:1, radon:1, nitrates/nitrites:1 | No |
| HI | Multiple sites:1, childhood leukemia:1 | Childhood leukemia:1 | EMF:1, pesticide exposures:1 | No |
| ID | NA | NA | NA | NA |
| IL | Multiple sites:118, all childhood cancers:10, all brain cancers:5, brain glioblastomas:3, pediatric leukemia:3, breast:3, osteogenic sarcoma:2, brain medulloblastomas:1, multiple myeloma:1, nervous system:1, all adenocarcinomas:1, leukemia:1, lung adenocarcinoma:1, lung:1, non-Hodgkin's lymphoma:1 | All cancers:7, breast:1, multiple myeloma:1, lung:1, all adenocarcinomas:1 | Not listed:137, unspecified exposure from nearby landfill:1, asbestos exposure from unspecified source:1, low-level exposure from radioactive burial ground:1 | No |
| IN | Breast:1, brain:2, pediatric brain/CNS:1, uterus:1, lung:1, leukemia:1 | None | TCE:1, PCE:1, other VOCs:1, benzene:1, PCBs:1, lead:1, cadmium:1, barium:1, 1,2- dichloroethane:1, vinyl chloride:1 | No |
| IA | Multiple sites:1, brain:1 | Brain:1 | Pesticides:1, EMF:1, radiation:1, solvents:1, animal viruses:1, N-nitroso-compounds:1, unspecified exposures from nuclear power plant:1 | No |
| KS | NA | NA | NA | NA |
| KY | All or multiple sites:2 | None | Technetium 99:1, dioxin:1, lead:1, benzene:1, 1,3-butadiene:1, 1,2- dichloroethane:1, ozone:1, chloroform:1, TCE:2, 1,1,2-trichloroethane:1, bromodichloromethane:1 | No |
| LA | Multiple sites:3, neuroblastoma:1 | Neuroblastoma:1 | Not listed:2, dioxin:2, arsenic:1, barium:1, cadmium:1, lead:1, chromium:1, mercury:1, PAHs:1, VOCs:1 | No |
| MD | Multiple sites:1 | None | naturally occurring radioactivity in groundwater:1, potential air contaminants from point sources:1, other:1 | No |
| ME | Multiple sites:1, brain:2, bone:1, lung:1 | Brain:1 | Unspecified exposures from pulp and paper mill and burning from municipal dump:1, chlorinated benzenes:1, unspecified exposures from nearby woolen mill complex:1 | No |
| MA | Multiple sites:8, brain:2, brain/CNS:3, childhood cancers:3, Ewing family of tumors:1, breast:4, leukemia:4, melanoma:1, liver:1, lung:2, cervix:1, Hodgkin's disease:3, abdomen:1, colon:1, testes:1, non-Hodgkin's lymphoma:3, thyroid:2, prostate:1, stomach:1, childhood brain:1, childhood leukemia:1, kidney:2, bladder:1 | Ewing family of tumors:1, breast:2, leukemia:2, melanoma:1, non-Hodgkin's lymphoma:1, prostate:1, brain:1, Hodgkin's disease:1, childhood leukemia:1 | Not listed:7, unspecified chemicals:1, unspecified chemicals in drinking water:2, unspecified chemicals in swimming pools:1, proximity to landfill:3, diesel fuel release:1, PCBs:3, dioxins:2, radioactive magnesium thorium waste:1, RF:1, TCE:4, PCE:3, petroleum hydrocarbons:1, VOCs:4, metals:2, unspecified exposures from a power plant:1, pesticides:1, unspecified exposures from industrial sites:1, THMs:1, vinyl and asbestos cement in water pipes:1, nearby cranberry bog:1, unspecified exposures from chemicals from army lab:1, industrial site:1, arsenic:1, barium:1, cadmium:1, benzene:1, asbestos:1, chemicals from former dye manufacturer including benzidene, dianisidine, o-tolidine, napthylamine:1, unspecified environmental sites:1 | One report (Costas et al., 2002) concluded “Results identified a non-significant association between potential for exposure to contaminated water during maternal pregnancy and leukemia diagnosis, (odds ratios 8.33, 95% CI 0.73–94.67). However, a significant doseresponse relationship (P ≶ 0.05) was identified for this exposure period. In contrast, the child's potential for exposure from birth to diagnosis showed no association with leukemia risk. Wide confidence intervals suggest cautious interpretation of association magnitudes.” |
| MI | Multiple sites:7 | None | VOCs:3, unspecified exposures from nearby packaging plant:1, unspecified exposures from nearby explosives plant and barrel dump:1, hydrogen chloride:1, cement kiln dust:1, lead:2, benzene:1, carbon tetrachloride:1, formaldehyde:1, ammonia:1, phenol:1, ammonium sulfate:1, sulfuric acid:1, copper:1, manganese:1, phenylisocyanate:1, naphthalene:1, phenol:1, 1,2,4-trimethylbenzene:1, antimony:1, barium:1, cadmium:1, chromium:1, zinc compounds:1 | No |
| MN | Multiple sites:2, breast:1, brain:1 | All sites:1 | Not listed:1, proximity to nuclear power plant:1, PAHs:1 | No |
| MS | Multiple sites:1 | None | Dioxin:1 | No |
| MO | Multiple sites:9, brain:4, benign brain tumors:1, breast:1, liver:1, lung:3, prostate:2, oral cavity:1, lymphoma:2, non-Hodgkin's lymphoma:1, childhood testicular:1, melanoma:2, pituitary:1, testicular:1, colon:1, stomach:1, thyroid:1, childhood leukemia:1 | None | Not listed:3, unspecified soil contamination:1, unspecified creek contamination:1, dioxin:3, unspecified landfill chemicals:1, EMF:1, charcoal kiln emissions:1, lead smelting chemicals:1, unspecified chemicals from beautification process:1, radiation fallout:1, unspecified chemicals from nearby oil refinery:1, pesticides:1, unspecified exposures from nearby explosives production plant:1 | No |
| MT | Multiple sites:1, pancreas:1 | None | diesel fuel:1, TCE:1, PCE:1 | No |
| NE | NA | NA | NA | NA |
| NH | Multiple sites:4 | None | Not listed:2, unspecified exposures from a coal tar waste deposit:1, arsenic:1, cadmium:1, chromium:1, nickel:1, lead:1, mercury:1, hydrogen chloride:1, dioxins and furans:1 | No |
| NJ | Multiple sites:2, all childhood cancers:1, brain/CNS:1, astrocytoma:1, sympathetic nervous system tumors:1, neuroblastoma:1, Wilms' tumor:1, bone:1, soft tissue sarcomas:1, leukemia:1, acute lymphocytic leukemia:1, lymphoma and other reticuloendothelial neoplasms:1, Hodgkin's disease:1, non-Hodgkin's lymphoma:1 | All childhood cancers:1, acute lymphocytic leukemia:1, brain and CNS:1, astrocytoma:1 | Styrene-acylonitrile trimer:1, TCE:3, PCE:1, other VOCs:1, arsenic:1, lead:1 | One report (NJDHSS, 2003b) concluded: “Several environmental factors of primary interest were found to be associated with leukemia in female children, specifically for the prenatal exposure time period. These associations were not found in male children.” |
| NM | Multiple sites:1, childhood cancers:1, thyroid:1, brain:1 | Thyroid:1 | radioactive air emissions and unspecified exposures from radioactive waste disposal:1 | No |
| NV | Childhood acute lymphocytic leukemia:1, childhood acute myelocytic leukemia:1 | Childhood leukemia:1 | Unspecified exposures from naval air station:1, jet fuel:1, infectious agent carried by naval aviators:1 | No |
| NY | Multiple sites:3, Hodgkin's disease:2, breast:1, childhood leukemia:1 | Breast:1 | Unspecified chemicals in drinking water and air:1, unspecified exposures from nearby landfill:1, EMF:1, pesticides:1, hazardous and municipal waste:1, VOCs:2, PCBs:2, PAHs:2, unspecified heavy metals:1, dibenzofurans:1, cadmium:1, chromium:1 | No |
| NC | Multiple sites:1 | None | Unspecified exposures from nearby landfill sites:1 | No |
| ND | NA | NA | NA | NA |
| OH | Multiple sites:9, all childhood cancers:3, leukemia:2, thyroid:1, Hodgkin's disease:1, non- Hodgkin's lymphoma:1, multiple myeloma:1, brain/CNS:2 | All childhood cancer:2, all sites:4 | Not listed:5, unspecified exposures from local industries:2, unspecified exposures from nearby landfill:1, unspecified exposures from ordnance plant and engineer depot:1, mirex:1, methane:1, VOCs:1, TCE:1, unspecified metals from nearby landfill:1, environmental tobacco smoke:1, farm chemicals:1, infectious agents:1, molds:1, paint and paint thinners:1, solvents:1, lead:1, electrical transformer oils:1, construction materials:1, plastics in recycling:1, hazardous wastes:1, grease and glue:1, phenolics:1, benzene:1, naphthalene:2, benzo(a)pyrene:1, semi-VOCs:1, cyanide:1 | No |
| OK | All or multiple sites:1 | None | Unspecified exposures from Superfund site:1 | No |
| OR | Brain:1, acute myelocytic leukemia:1 | None | Pentachlorophenol:1, creosote:1, ammonia copper zinc arsenate:1, PAHs:1 | No |
| PA | Multiple sites:3, osteosarcoma:1, colon:1, polycythemia vera:1, brain:1, breast:1, lung:1, stomach:1, leukemia:1 | All sites:1, polycythemia vera:1 | Unspecified exposures from former mill:1, unspecified exposures from acid mine tailings and waste-coal power plants:1, boron:1, trichloroethane:1, TCE:1, PCE:1, chloroform:1, hydrogen sulfide:1, sulfur dioxide:1, PAHs:1, aluminum:1, copper:1, lead:1, mercury:1, vanadium:1, zinc:1 | No |
| RI | NA | NA | NA | NA |
| SC | Multiple sites:2, pleura:1 | All sites:1, pleura:1 | Asbestos:1, dioxins and VOCs from nearby incinerator:1 | One report (Aldrich and Bolick, 1999) concluded “The level of pleural cancer deaths in this tri-county region of South Carolina is similar to that found in other parts of the country where asbestos related industries have been concentrated...” |
| SD | NA | NA | NA | NA |
| TN | Multiple sites:1 | None | Radiation | No |
| TXc | Multiple sites:96, childhood cancer:6, colon and rectum:2, pseudomyxoma peritonei:1, lung:4, liver:4, thyroid:2, multiple myeloma:1, brain:4, brain/CNS:1, glioblastoma:1, childhood brain cancer:1, kidney:2, breast:2, leukemia:1, cervix:1, leukemia:5, childhood leukemia:3, multiple myeloma:1, bladder:1, all lymphomas:1, non-Hodgkin's lymphoma:2, Hodgkin's disease:2, soft tissue sarcoma:1 | Multiple sites:4, childhood cancer:1, brain/CNS:1, stomach:1, multiple myeloma:1, liver and intrahepatic bile duct:2, Hodgkin's disease:2, lung:1, sarcoma:1, breast:1 | Not listed:44, unspecified chemicals in drinking water:7, unspecified exposures from golf course:2, landfill:5, nearby industry:4, asphalt plant:1, poultry farms:1, dump sites:1, creosote plants:1, fertilizer plant:1, petroleum distribution facility:1, petrochemical plants:2, lake:1, closed air base:1, Superfund sites:1, nuclear waste dump:1, refineries:2, army munitions plant:1, power plant:1, oil and gas wells:1, army training site:1, pipelines:1, arsenic:10, PCE:1, TCE:5, dichloroethene:3, vinyl chloride:1, THMs:4, benzene:9, 1,3-butadiene:3, radiation:3, EMF:1, nitrates:2, 1,2-dichloroethane:1, manganese:3, PCBs:2, DDT:2, toxaphene:2, chromium:5, cadmium:3, copper:2, silver:2, mercury:2, selenium:2, aluminum:2, barium:2, beryllium:2, vanadium:3, lead:3, antimony:2, nickel:3, zinc:2, cobalt:1, ammonia:1, sulfur dioxide:1, aluminum oxide:1, ethylene oxide:1, propylene oxide:1, vinyl acetate:1, acrylonitrile:1, asbestos:2, PAHs:2, pentachlorophenol:1, dioxins/furans:1, VOCs:1, diesel exhaust:1, disinfection byproducts:1, occupational lignite exposure:1, pesticides:1 | No |
| UT | Multiple sites:6, brain:1, lung:1, soft tissue:1, lymphocytic leukemia:1, non-Hodgkin's lymphoma:1 | Brain:1, lung:1 | Proximity to vanadium/uranium processing mill:1, dioxin:1, unspecified chemicals in groundwater from air force base:1, TCE:1, PCE:1, carbon tetrachloride:1, perchlorate:1, proximity to gravel pit, asphalt plant, storage facility:1, nitrates in ground water:1 | No |
| VT | NA | NA | NA | NA |
| VA | Multiple sites:1 | None | Unspecified chemicals from nearby building material plant:1 | No |
| WA | Multiple sites:2, childhood cancers:1, acute lymphocytic leukemia | Acute lymphocytic leukemia:1 | Ethylene dibromide:1, 1,2-dichloropropane:1, PAHs, mercury and unspecified chemicals from nearby former missile launch site:1, VOCs:1, semivolatile compounds:1, heavy metals:1, PCBs:1, pesticides:1, PAHs:1 | No |
| WV | NA | NA | NA | NA |
| WI | Multiple sites:1, chronic lymphocytic leukemia:1 | Chronic lymphocytic leukemia:1 | Pesticides:1, VOCs:1, chloroform:1, carbon tetrachloride:1 | No |
| WY | NA | NA | NA | NA |
a
May not add to total as some clusters may include several cancer categories. “Multiple sites” indicates that the community concern did not center on one or more specific cancer sites, but rather noted a general increase in cancers. Similarly, “all childhood cancers” indicated a community concern for childhood cancer generally, not for a specific type of childhood cancer.
b
Defined as evidence of statistically significant elevation in cancer incidence consistent across population groups for the a priori stated cancer site(s).
c
Texas: most community concerns were for “all cancers” but the investigation typically subdivided the cancers by type. For Texas, we include those cluster investigations in which Texas DOH recommended further investigation as “confirmed clusters”; further investigation may be proposed without evidence of a confirmed cluster.
CNS, central nervous system; DDT, dichlorodiphenyltrichloroethane; EMF, electromagnetic field; NA, not applicable; RF, radiofrequency; PAHs, polyaromatic hydrocarbons; PCBs, polychlorinated biphenyls; PCE, perchloroethylene; TCE, trichloroethylene; THMs, trihalomethanes; VOCs, volatile organic chemicals.