Cancer Inquiry

A Cancer Inquiry is conducted to determine if there is an unusually high number of cases of a specific type of cancer in a community. Information is gathered and reviewed to decide if a certain type of cancer is occurring more than expected in a specific area (city, county or zip code region). If a higher-than-expected number of cases of a particular type of cancer are found in the area, the Cancer Inquiry will attempt to determine if there is a common cause for the cancer cases.

A Cancer Inquiry:

• Responds to public perception:
  • Of increased cancer in their community.
  • That the perceived increase in cancer must be from exposure to an environmental pollutant.
• Informs public that:
  • Cancer is more common than most people realize.
  • Contrary to public perception, cancer is not usually caused by pollution or other environmental factors.
  • Most of the causes of cancer that we know about are related to lifestyle.

Signs of Cancer Excess

• Rare type of cancer is involved.
• Large number of cases of the same type of cancer reported in a small population.
• Cancer is occurring in an unexpected age group.
• Possible exposure to cancer causing agent.
• Cancer is not related to behavior.

How a Cancer “Cluster” is Determined

• The Cancer Inquiry Protocol is a systematic way to determine if the area of concern is above average in cancer excess.
• If the area is above average, the Cancer Inquiry Protocol must determine if it is due to exposure to an agent or to randomness.

How the Cancer Inquiry Process Works

• It usually begins with a phone call or letter to the Bureau of Cancer and Chronic Disease Control in which the inquirer discusses the concern with a staff member.
• Information about cancer risk factors, clusters and forms to initiate an inquiry are sent if requested.
• If the inquirer does not return required information on Cancer Inquiry forms, a letter is sent stating the inquiry will be closed.
• If the forms are returned:

• Cases are confirmed.
• A preliminary report is written and presented to the Cancer Inquiry committee with recommendations.
• The Cancer Inquiry committee decides if the inquiry meets the criteria from the protocol for more research.

Cancer Inquiry Committee

• Committee members represent local, state and federal health and environmental agencies, and concerned citizens.
• The Cancer Inquiry Committee reviews reports and determines if the inquiry should proceed to the next level.

Cancer Inquiry Protocol – A 4-Stage Process

• Level 1: Basic information gathering.
• Level 2: Specific risk factor research, epidemiological analysis and statistical testing.
• Level 3: Environmental research, epidemiological analysis and statistical testing.
• Level 4: Feasibility study.