Report targets cancers among African Americans
by Dick Peterson
Public Relations
An intensive, five-year study of cancer incidence among residents of 22 counties along both sides of the Savannah River has found no surprises, but underscores the need to identify and prevent two specific cancers far too common in African American men and women.
Dan
Lackland, Dr.PH.
“We compared the region’s cancer rates with other parts of the country with regards to risks from radiological and hazardous materials,” said MUSC epidemiologist Dan Lackland, Dr.PH.
John
Dunbar, Dr.PH.
Lackland, with epidemiologist John Dunbar, Dr.PH, headed a cooperative effort with Georgia investigators to build a cancer registry. Study data, now contained in the registry, is summarized in a report released late last year and identifies high rates of esophageal cancer among African American men and cervical cancer among African American women.
“The registry grew out of public concern about cancer and the proximity of residents to the Savannah River Site nuclear power plant,” Lackland said.
As a result, the Department of Energy funded the Savannah River Health Information System, a cooperative effort between the MUSC Department of Biometry and Epidemiology and the Department of Epidemiology at Emory University’s Rollins School of Public Health.
The two institutions were each responsible for their respective sides of the Savannah River, which defines the border between South Carolina and Georgia. The report includes cancer incidence, stage at diagnosis and histological type for cancers identified by the geographic cancer registry established in the vicinity of the power plant.
“Cancers commonly associated with exposure to radiation, like leukemia and thyroid cancers, were conspicuously lower compared to the rates from other populations and regions. Also, we were not able to detect geographic patterns, called ‘hot spots’ or ‘clusters,’ of these cases in the region,” Lackland said.
The exceptions proved to be esophageal cancer in African American men and cervical cancer in African American women. While this is the first analytical documentation of the cancer rates, the higher risks of these cancers in South Carolina has been a clinical finding for some time.
As an epidemiologist, Lackland can only speculate on reasons for the two cancer anomalies, except to say that esophageal cancer commonly has risk factors tied to lifestyle and cervical cancer usually arises in women who fail to schedule annual Pap smear exams.
Another concern from the report relates to the racial disparity in stage at diagnosis. The findings indicate that African American men and women are diagnosed at later stages of cancer than white men and women. Prognoses of cancer are substantially better when cancer is diagnosed at earlier stages. Cancers such as breast, cervical and prostate, diagnosed at later stages suggest less access to medical care and use of early detection practices.
Lackland said the system’s registry research is continuing in the Savannah River Region, but paying more attention to the details. “We want to identify the risk factors involved in the esophageal and cervical cancers among African Americans,” he said.
Once risk factors contributing to the high incidence of the two cancers are identified, targeted screening and educational campaigns can be launched to drive the numbers down.
Noting the highly preventable nature of cervical cancer when detected by Pap smear in its early stages, Lackland said, “No woman should ever have metastatic cervical cancer. Yet we have some of the highest rates in the country.”