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Medical experts explain state cancer data for LI

The information, they say, doesn't tell the larger story about cancer on the Island, or even in three hamlets that have elevated incidence of four forms of cancer.

In Centereach, Farmingville and Selden, the four high

In Centereach, Farmingville and Selden, the four high clusters (of bladder, leukemia, lung, thyroid cancer) overlap. In the area, there are 311 cases of lung cancer, which is 56 percent above the state rate, 112 cases of bladder cancer, 50 percent above; 98 cases of thyroid cancer, 43 percent above; and 87 cases of leukemia, 64 percent above. Photo Credit: New York State Department of Health

Scientists used sophisticated mapping techniques and statistical analyses to help them home in on three Long Island communities that had higher-than-expected rates of four forms of cancer — leukemia, lung, bladder and thyroid.

But medical experts and patients’ advocates say the information doesn’t tell the larger story about cancer on the Island, or even in the targeted hamlets of Centereach, Farmingville and Selden.

To start with, Dr. Yusuf Hannun of the Stony Brook Cancer Center said, it’s important to understand what kind of research the state has conducted to unmask an elevated number of cases.

“This is incidence data,” Hannun said, referring to a statistical measure widely used by epidemiologists, medical scientists who study the distribution of diseases in populations.

Incidence is about the proportion of cases within a specific time frame. The state’s research was an examination of four types of cancer in three hamlets during a five-year period, from 2011 to 2015. It shouldn’t be confused with another measure known as prevalence, which would indicate how widespread the cancers are in a population.

Residents might mistake the new findings as suggesting that leukemia, lung, bladder and thyroid malignancies are the most prevalent ones in the three communities. They’re not — breast cancer is, said Hannun, the cancer center’s director.

The new research, which was released to the public Tuesday, marks the first phase into a deeper analysis of cancer incidence patterns in specific New York communities. The others are Staten Island, Warren County, East Buffalo and Western Cheektowaga in Erie County.

Epidemiologists used a broad range of data, such as U.S. Census information and statistics from the New York State Cancer Registry, to ferret out areas in the state with higher-than-expected cancer incidence. Researchers also constructed maps to illustrate where the cases were found.

They uncovered 608 cancers that had occurred at elevated rates in Centereach, Farmingville and Selden, an area with 65,000 residents.

Of that total, 311 were lung cancers, which was 56 percent higher than the state rate for that disease. The three-community area also had 112 cases of bladder cancer, which was 50 percent higher than the state rate; 98 cases of thyroid cancer, 43 percent higher; and 87 cases of leukemia, which occurred at a rate that was 64 percent higher.

While some residents have questioned whether just living in their communities has put them at an increased risk, experts such as Hannun said the data should be viewed cautiously.

“We need to know how strong these data are,” Hannun told Newsday in an interview.

“I don’t want people in those areas to think they are targeted for cancer, and it’s difficult to say what it all means until those data are vetted,” Hannun said.

“Is what we’re seeing due to better detection or is it a genuine increase in these cancers?” asked Hannun, who attended two meetings this week conducted by the state on its findings.

The deputy state health commissioner, Brad Hutton, also urged caution, noting that being a resident in these hamlets would not make individuals vulnerable to cancer. That said, Hutton vowed the state would extensively study any possible environmental exposures that could be linked to an uptick in cancer incidence. Industries in the area, water quality and air pollution data will be analyzed. The $500,000 initiative was launched last fall by Gov. Andrew M. Cuomo.

A strong argument against an environmental association emerges from the deep well of data on how cancers develop in the first place. Malignancies evolve over years — anywhere from five to 40 — before overt symptoms are noticed. That kind of time frame not only is long, but suggests some individuals whose cases were tallied in the investigation probably had cancers that developed years earlier while residing elsewhere.

“For each of the cancers we will be doing a review, looking at tumor data and cell type,” Hutton said.

Demographics will be considered because “cancers vary by race and ethnicity, so we will be looking into those variables as well,” added Hutton, who was a key epidemiologist in the major study of breast cancer on Long Island in the 1990s. That analysis involved extensive research of hundreds of residents who developed the disease.

Scientists at the National Cancer Institute were among the collaborators on the project that examined a vast range of possible breast cancer causes. Electromagnetic radiation and other gene-altering exposures were studied in the research, which ultimately concluded that age and late-in-life childbearing were among the primary factors for the elevated risk, Hutton said.

A similar kind of expected outcome could occur in this research. Three of the four cancers — adult leukemia, bladder and lung cancers — have powerful links to smoking, Hutton said.

A final report is still many months away.

Hannun predicted lung cancer diagnoses are likely to increase in the three communities and elsewhere in Suffolk, not because smoking is on the rise but because Stony Brook Hospital is broadening a screening program. Low-dose CT scans can reveal tiny lung cancers that otherwise would have eluded detection.

“This is just to say if you start looking for something, you’ll probably find it,” Hannun said.

But as a spotlight has been focused on the three hamlets, Long Island residents who live outside the study zone said they would like to see the state analyze cancer where they live. Their neighborhoods have multiple cancer cases and no one can explain why.

Patrick Nicolosi said more than a dozen people, including himself, have been diagnosed with cancer in his neighborhood in Elmont. He’s mystified why his part of Long Island isn’t getting state scrutiny.

“I have medullary thyroid cancer, the worst kind,” Nicolosi said.

His cancer, which can occur as a result of radiation exposure, has spread to his right lung and the wall of his chest. The disease is incurable, said Nicolosi, who explained he has had routine dental and medical X-rays but isn’t aware he has had excessive exposure.

Nicolosi’s neighbors have been diagnosed with breast cancer, a rare form of leukemia, lung cancer and other malignancies. A friend who used to live nearby has glioblastoma, the most aggressive form of brain cancer. Nicolosi worries about the health of streams that flow near his home. The water frequently is an eerie green containing pollutants, Nicolosi said.

Southold resident Holly Lanzetta has a 7-year-old son, Sam, who was diagnosed with leukemia. He has completed treatment and is healthy now.

But Lanzetta said she was stunned when she couldn’t find any information about cancer rates in the Southold area, especially when trying to make sense of her son’s diagnosis. Lanzetta described her community as “a hotbed of cancer.”

“I have friends with breast cancer, friends with lymphoma,” Lanzetta said. “My eyes are open more to cancer. It seems like more people out here are being diagnosed, and there are no answers why these people are more affected.”

Hutton, the deputy health commissioner, said it is important to understand what cancer is: “Cancer isn’t one disease; it’s more than 100 different diseases, and all of them have differentcontributing factors.”

Aging is the single most important risk factor for cancer because of mutations that accumulate in DNA. Other risks include smoking, alcohol use, exposure to radiation or carcinogens, obesity and family history.

While malignancies are rare in children, they are not unusual in adults, Hutton added, noting that one in two men and one in three women will be diagnosed with cancer at some point in their lives.

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