Why haven investigations of cancer clusters been useful in identifying environmental causes of cancers?
Over the years, nearly every neighborhood cancer “cluster” investigation has failed to identify any environmental cause. This is not for lack of trying, but because cancers are very complex diseases. Methods that work well to identify the cause of an infectious disease outbreak do not work well with neighborhood cancer clusters. The reasons include: Cancers take a long time to develop. For most cancers, the period between exposure to a carcinogen and the development of cancer may be ten to twenty years or more. By the time cancer rates have increased in an area, the carcinogen may no longer be measurable in the environment. People change residences. In many cases, by the time a person is diagnosed with a cancer, he or she no longer lives in the area where an exposure may have occurred. Cancer registries have no way to track where people lived before or after developing a cancer. Residential cancer clusters contain few cases. Even if the cancer rate in an area is found to be “statistica