Monday, September 8, 2003

Ky. cancer cases may be 'cluster'


Researcher finds excessive rates in Jefferson Co.

The Associated Press

LOUISVILLE - A University of Louisville researcher says he's identified an excessive number of cases of lung cancer in western and southern Jefferson County.

Looking at reported cases of cancer, ZIP code by ZIP code, epidemiologist and associate professor Timothy Aldrich attributed the large majority to tobacco smoke, but said it's not clear on what role environmental and occupational contaminants play.

"The Jefferson County piece is our local version of a much larger picture," said Aldrich, of the university's School of Public Health and Information Sciences. "The state has enormously high lung cancer rates."

In his draft study, done at the request of the Courier-Journal newspaper, Aldrich reported what he said were excessive rates and "evidence of clustering" for bladder and cervical cancers and leukemia in various locations around Jefferson County. The study also identified 16 ZIP codes with high breast cancer rates, but Aldrich said he found no apparent pattern to their occurrence.

Aldrich's study is the first to address some of the health questions raised by Louisville-area air monitoring that has found numerous chemicals or compounds at levels federal, state and local environmental regulators consider unsafe. It follows one published in 1997 by the Louisville and Jefferson County Board of Health that found no clusters but identified the highest cancer death rates in western and southwestern Jefferson County, attributing them largely to lack of early diagnosis and treatment.

Aldrich said he found that it's likely the public doesn't have to worry about the environment as a cause of three categories of cancer sometimes associated with chemical pollutants: pediatric cancers, brain cancer and liver cancers. In all three, he said, he found no evidence of excessive rates or clustering.

But Aldrich said he cannot rule out that hazardous air pollutants might explain some of the excess lung, bladder and leukemia cancers in certain ZIP codes and may cause or contribute to other illnesses he did not study.

Other medical experts have also said smoking and poor air quality could combine to produce more lung cancers.

"The environment (as a cause of cancer) is not immaterial, but you have to keep it in perspective," Aldrich said. "I don't want to tell people it isn't important - it's important."

To answer the question of how important it is, he and several other researchers at UofL have begun a two-year research project to determine what part, if any, environmental or occupational contaminants play in Louisville's lung cancers.

Aldrich and other Louisville medical experts said lifestyle factors such as diet, smoking and alcohol consumption, along with genetics, play the dominant role in determining whether someone gets cancer, and prevention measures should continue to focus on lifestyle factors.

"All of these factors come together in very complicated ways, in addition to air quality," said Dr. Donald Miller, director of the James Graham Brown Cancer Center at the University of Louisville. "Clearly if you are looking at cancer prevention targets, smoking is at the head of the list."

Air pollution "is a big problem," said Dr. Wayne Tuckson, a colorectal surgeon who worked on the 1997 cancer study. "But it's just another one of the problems."

Aldrich is scheduled to discuss his research at a meeting Thursday of the Rubbertown Community Advisory Council that will include several presentations from university experts.

The Louisville Metro Health Department is studying Aldrich's findings, and Metro Mayor Jerry Abramson and metro government's Air Pollution Control District have promised to take residents' air pollution concerns seriously.

Art Williams, director of the air district, said the agency will continue its efforts to curb hazardous air pollutants.

"We will move as aggressively as we can to reduce air toxics to safe levels," Williams said.




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