| munity cancer clusters are viewed quite | | | | Community cancer clusters are viewed quite |
| differently by citizen activists than by | | | | differently by citizen activists than by |
| epidemiologists. Environmentalists and concerned | | | | epidemiologists. Environmentalists and concerned |
| local residents, for instance,might immediately | | | | local residents, for instance,might immediately |
| suspect environmental radiation as the culprit | | | | suspect environmental radiation as the culprit |
| when a high incidence of cancer cases occurs | | | | when a high incidence of cancer cases occurs |
| near a nuclear facility. | | | | near a nuclear facility. |
| Epidemiologists,in contrast, would be more likely to | | | | Epidemiologists,in contrast, would be more likely to |
| say that the incidences were "inconclusive'or the | | | | say that the incidences were "inconclusive'or the |
| result of pure chance.And when a breast cancer | | | | result of pure chance.And when a breast cancer |
| survivor, Lorraine Pace,mapped 20 breast cancer | | | | survivor, Lorraine Pace,mapped 20 breast cancer |
| cases occurring in her West Islip,Long | | | | cases occurring in her West Islip,Long |
| Island,community, her rudimentary research | | | | Island,community, her rudimentary research |
| efforts were guided more by hope that a | | | | efforts were guided more by hope that a |
| specific environmental agent could be correlated | | | | specific environmental agent could be correlated |
| with the cancers than by scientific method. | | | | with the cancers than by scientific method. |
| When epidemiologists study clusters of cancer | | | | When epidemiologists study clusters of cancer |
| cases and other noncontiguous conditions such as | | | | cases and other noncontiguous conditions such as |
| birth defects or miscarriage,they take several | | | | birth defects or miscarriage,they take several |
| variables into account,such as background rale- | | | | variables into account,such as background rale- |
| (the number of people affected in the general | | | | (the number of people affected in the general |
| population),cluster size, and specificity my notable | | | | population),cluster size, and specificity my notable |
| characteristics of the individual affected in each | | | | characteristics of the individual affected in each |
| case).If n cluster is both large and specific, it is | | | | case).If n cluster is both large and specific, it is |
| easier for epidemiologists to assign blame. | | | | easier for epidemiologists to assign blame. |
| Not only must each variable be considered on its | | | | Not only must each variable be considered on its |
| own,but it must also be combined with | | | | own,but it must also be combined with |
| others.Lung cancer is very common in the general | | | | others.Lung cancer is very common in the general |
| population. Yet when a huge number of cases | | | | population. Yet when a huge number of cases |
| turned up among World War shipbuilders who had | | | | turned up among World War shipbuilders who had |
| all worked with asbestos, the size of the cluster | | | | all worked with asbestos, the size of the cluster |
| and the fact that the men had had similar | | | | and the fact that the men had had similar |
| occupational asbestos exposures enabled | | | | occupational asbestos exposures enabled |
| epidemiologists to assign blame to the leprous | | | | epidemiologists to assign blame to the leprous |
| mineral. | | | | mineral. |
| Although several known carcinogens have been | | | | Although several known carcinogens have been |
| discovered through these kinds of occupational or | | | | discovered through these kinds of occupational or |
| medical clusters, only one community cancer | | | | medical clusters, only one community cancer |
| cluster has ever been traced to an environmental | | | | cluster has ever been traced to an environmental |
| cause. I leally officials often discount a | | | | cause. I leally officials often discount a |
| community's suspicion of a common | | | | community's suspicion of a common |
| environmental cause because citizens tend to | | | | environmental cause because citizens tend to |
| include cases that were diagnosed before the | | | | include cases that were diagnosed before the |
| afflicted individuals moved into the neighborhood. | | | | afflicted individuals moved into the neighborhood. |
| Add to this the problem of cancer's latency. Unlike | | | | Add to this the problem of cancer's latency. Unlike |
| an infectious disease such as cholera, which is | | | | an infectious disease such as cholera, which is |
| caused by a recent exposure to food or water | | | | caused by a recent exposure to food or water |
| contaminated with the cholera bacterium, cancer | | | | contaminated with the cholera bacterium, cancer |
| may have its roots in an exposure that occurred | | | | may have its roots in an exposure that occurred |
| 10 to 20 years earlier. | | | | 10 to 20 years earlier. |
| Do all these caveats mean that the hard work of | | | | Do all these caveats mean that the hard work of |
| Lorraine Pace and other community activists is for | | | | Lorraine Pace and other community activists is for |
| nothing? Not necessarily. Together with many | | | | nothing? Not necessarily. Together with many |
| other reports of breast cancer clusters on Long | | | | other reports of breast cancer clusters on Long |
| Island, the West Islip situation highlighted by Pace | | | | Island, the West Islip situation highlighted by Pace |
| has helped epidemiologists lay the groundwork for | | | | has helped epidemiologists lay the groundwork for |
| a well-designed scientific study. | | | | a well-designed scientific study. |