JASoN Ro THE / ALAMY
and cancer advocates agree
that it would be easier for public
health officials to investigate
cancer clusters if cancer registries
collected more information: not
only where a person lived at the
time of diagnosis, but where they
lived in the past and where they
worked. others, like Guinan, point
to a need for better collection of
tissue samples and for the genetic
analysis of tumors.
Some, like Witten, think new
technologies will make this type
of work easier. “When public
health officials talk about cancer
clusters, they always talk about all
the studies they have done over
the years where they couldn’t
find anything,” he says. “But
my thought on that is: I started
my career in 1980 and the gene
microarray I’m using wasn’t around
five years ago.”
It also might help if researchers
develop new ways to study
clusters, beyond today’s case-control method, which tries to
identify differences between those
in the community who developed
the cancer (the cases) and those
who did not (the controls). The
problem officials typically face,
says Wiemels, “is that most of
the time the cluster is so small
that the case-control research
method is virtually destined to
fail.” And, of course, it can’t take
into account that while both the
cases and controls might have
had the same exposure, only the
cases might have had previous
exposures that pushed them to go
on to develop cancer—which, says
Wiemels, is one of the operating
theories about what might have
happened in Fallon.
Equally important, health
officials say, is how experts
respond to a community’s
concerns. Neutra says that his
experience has shown him that
“the public outcry and demand
for studies typically occur when
there hasn’t been a prompt
response and people begin to
feel ignored.” There will be times
when it’s right to investigate. And
others when it’s not. “And even
if you do identify an agent that
might be responsible,” he notes,
“it might never be possible to
prove it’s the cause.”
CR | Page No. 41 | www.CRmagazine.org
