Cancer: Measures and Data
Why is cancer an environmental public health concern?In Washington, cancer was the leading cause of death for adults ages 45 to 84 in 2010 (Washington State Department of Health Center for Health Statistics), and the second leading cause of death in the nation (National Center for Health Statistics). Factors that influence risk for cancer include lifestyle choices such as: cigarette smoking, alcohol consumption, diet, exercise, and exposure to certain medical drugs and hormones. Environmental factors include exposure to radiation, some fibers, metals, fine particles, diesel exhaust, viruses, bacteria, and toxins from fungi. Chemicals that may be present in air, water, soil, or food, in the home or in the workplace can also be environmental factors for cancer.
The International Agency for Research on Cancer (IARC) evaluates cancer risk posed by specific chemicals (see IARC Monographs on the Evaluation of Carcinogenic Risks to Humans). The American Cancer Society provides a comprehensive list of carcinogens which includes additional information from the federal National Toxicology Program (see Known and Probable Human Carcinogens). It is clear that a proportion of cancers could be prevented by efforts to reduce exposures to environmental carcinogens.
How is cancer tracked?In Washington, cancer has been a reportable condition since 1990. The Washington State Cancer Registry collects cancer case information from many reporting sources, including physicians, medical clinics and hospitals, radiation and oncology centers, and pathology labs. The general types of cancer information reported to the State Cancer Registry consists of the following: (a) patient and facility demographics including confidential information; (b) cancer identification; (c) staging or extent of disease information at the time of diagnosis; (d) treatment information; (e) follow-up information including vital status, date of last contact, and tumor status.
Among chronic diseases tracked in the United States, the cancer surveillance system is the most sophisticated and complete. The North American Association of Central Cancer Registries (NAACCR) develops and promotes uniform data standards for cancer registration, and certifies state registries to ensure that these data are of high quality and that their confidentiality is protected. The CDC Cancer Prevention and Control Program and the NIH National Cancer Institute (NCI) have more information about cancer surveillance.
The Washington State Cancer Registry maintains an online query system for the 25 leading cancers at “WSCR Data Online“. WSCR data are compatible with data available at web portals in the national Tracking network.
What is public health doing to prevent cancer?In general, the public health community works to prevent cancer and increase early detection and treatment of cancer
through a variety of programs and in partnership with many stakeholders.
The Washington Comprehensive Cancer Control
Partnership published a plan that outlines strategies to reduce preventable cancers and increase early diagnosis in Washington.
The Partnership is coordinated by the Washington DOH
Comprehensive Cancer Control Program
at the Washington State Department of Health, and is funded by the CDC
National Comprehensive Cancer Control Program.
Goal 8 of the plan provides specific actions that can “Reduce the impact of environmental carcinogens on
cancer incidence and mortality in Washington State.” The plan prioritizes preventing exposure to arsenic, radon, and diesel exhaust because:
1) they are known or probable environmental carcinogens with a potentially high impact on public health in Washington, and
2) there are clear, effective actions that could be taken to prevent exposure to these carcinogens.