|
Definition
A cancer cluster is defined as a greater-than-expected number of cancer cases that occurs within a group of people in a geographic area over a period of time.
Challenges in identifying
The complex nature of cancer makes it inherently challenging to identify, interpret, and address cancer clusters.
"Cancer" is a term representing many diseases with a variety of causes. The time between exposure to a cancer-causing agent, or the existence of other risk factors, and the development of cancer can be decades; therefore, causes are hard, and in some cases impossible, to identify.
Some racial and ethnic groups have a higher incidence of and deaths due to cancer. Such disparities may be due to multiple factors, such as late stage of disease at diagnosis, barriers to health care access, history of other diseases, biologic and genetic differences, health behaviors, differences in exposures to carcinogens in the environment and the workplace, and other risk factors.
Characteristics
What first appears to be a cancer cluster may not be one after all. A review of the situation may show that the number of new cancer cases is in the expected range for the population and therefore that the cases do not represent a cancer cluster. Cancer cases are more likely to represent a cancer cluster if they involve (1) one type of cancer, (2) a rare type of cancer, or (3) a type of cancer in a group not usually affected by that cancer, such as a cancer in children that is normally seen in adults. However, cases of common cancers are those most often perceived and reported by the public as being part of a cancer cluster.
Identification
The investigators develop a "case" definition, a time period of concern, and the population at risk. They then calculate the expected number of cases and compare them to the observed number. A cluster is confirmed when the observed/expected ratio is greater than 1.0, and the difference is statistically significant.
Usually, a local or state health department provides the first response to a suspected cancer cluster. The local or state health department gathers information about the suspected cancer cluster (e.g., types of cancer, number of cases, addresses and occupations of those people with cancer, possible causes), develops and applies the case definition, and determines whether there is a greater-than-expected number of cases.
Interpretation
Confirmation of a cancer cluster does not necessarily mean that there is any single, external cause or hazard that can be addressed. A confirmed cancer cluster could be the result of any of the following:
- chance
- miscalculation of the expected number of cancer cases (e.g., not considering a risk factor within the population at risk)
- differences in the case definition between observed cases and expected cases
- known causes of cancer (e.g., smoking)
- unknown cause(s) of cancer.
Follow-up investigations can be done, but can take years to complete and the results are generally inconclusive (e.g., usually, no cause is found).
Reporting
If you suspect a cancer cluster in your community or workplace, or if you'd like information such as cancer statistics or trends in your area, first contact your local or state health department or state cancer registry. For information about how to contact your state or local health department, go to http://www.cdc.gov/other.htm#states. For state cancer registry contact information, go to http://www.cdc.gov/cancer/npcr/statecon.htm#list.
Prevention and Early Detection
Concern about cancer and cancer clusters provides an opportunity for people to learn about how they can prevent cancer or identify it early. Sixty-five percent of public inquiries about cancer clusters involve cancers for which screening and preventive measures exist. The best steps that people can take regarding cancer are to (1) educate themselves about their personal risk and risk factors for cancer, (2) avoid these risks, and (3) take advantage of recommended cancer screenings.
The following Web sites provide information on cancer in general, risk factors, and recommended screenings:
This fact sheet is for information only and is not meant to be used for self-diagnosis or as a substitute for consultation with a health care provider. If you have any questions about the disease described above or think that you may have a parasitic infection, consult a health care provider.
Click here for more on Cancer Clusters
Or click here
Or here
Back to A-Z Health Conditions List
|
