CTS cancer study deserves continued follow-up

I can understand the concern of Dave Ogren and the Concerned Citizens for a Clean and Safe Asheville [“Study Finds No Cancer Clusters near CTS Site,” Aug. 13]. When you see lots of friends and neighbors diagnosed with cancer, you do begin to wonder about what caused it. Living near an industrial site increases the anxiety about toxic waste. So the state does a study and tells you everything is OK, but it doesn’t seem OK at all.

This is an extremely complicated issue. Cancer is not just one disease and doesn’t have just one cause. Lung cancer isn’t equal to liver cancer. What the state study [at the CTS site] did was look for the types of cancers associated with TCE exposure. To get valid information, you must eliminate as many other variables as possible. There may be lots of lung-cancer cases in the area, but how many [people] in the neighborhood smoke? How many in the area have a family history of breast, prostate or colon cancer? Add to that the question of how long people have lived in the area: Is the exposure of someone who moved in the last year equal to the exposure of a longtime resident? How far away from the CTS site is far enough to not be exposed to TCE? It’s a little like trying to count hickory trees in one grove of a forest filled with many different kinds of trees.

The state study looks to be well-designed to answer the question: “Did exposure to TCE from the CTS site cause more than the expected number of cases of the types of cancer known to be related to TCE?” The only problem with the study is the small sample size, which can’t be helped. The state needs to keep monitoring the area for any additional cases, and look further for former residents who might have been overlooked because they have moved.

As much as Dave Ogren wants to go door to door and count cancer cases, the information gained won’t be of any help. It would just add in more variables: more trees, a bigger grove. Let the statisticians crunch the numbers; they know how to design the studies properly. Let the neighbors be vigilant, call in the experts and make sure the studies get done, but spend their energy in supporting each other as only friends and neighbors can.

— Jane Arfa
Former cancer epidemiologist

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