North Shore AIR

North Shore Air Inventory Report

Funded by the Environmental Protection Agency

Health Impacts: Cancer

Cancer is the No. 2 cause of death in Massachusetts, accounting for 24% of all deaths in 2003, the most recent year for which statistics are available. The leading cause of cancer death is lung cancer, which accounts for 27% of cancer deaths.

Scientific studies are beginning to establish a clear relationship between air pollution and lung cancer. In the American Cancer Society survey on Cancer Prevention, after reviewing health data on hundreds of thousands of people in over 100 cities across the United States, researchers found that "there was no level of air pollution that was safe, and that the more air pollution increased, the higher the risk became of dying from lung cancer, heart disease, or from any cause." (1) This was corroborated by a study in Norway that followed 16,000 men for 27 years. Researchers concluded that the stronger the concentration of the air toxin nitrogen oxide which is a component of smog, the greater the chance of developing lung cancer. (2)

Cancer is a problem for residents of Essex County. As can be seen in the following chart, the US EPA places residents of the Boston area, including the North Shore, in the highest percentile of lifetime cumulative cancer risk.

Figure 3

The Clean Air Act set as a goal that lifetime cancer risks from exposure to hazardous air pollutants should be no more than one in one million. Scorecard, an environmental rating project of Environmental Defense, estimates that the average individual living in Essex County has an increased cancer risk of 840 times this amount, based on 1996 EPA air pollution estimates. This means that Essex County residents are estimated to be experiencing 840 times the acceptable limit for increased cancer risk due to air pollution. In fact, the EPA estimates that in New England, 1,900 additional cancer cases per year, corresponding to 3% of all new cases, are associated with exposure to air toxins.

The State of Massachusetts Cancer Registry shows that age-adjusted rates on both cancer incidence and mortality are higher in Massachusetts when compared with the rest of the country. The Registry also shows that the five year average incidence of cancers combined were higher than expected for both males and females in Salem and Marblehead 1998-2002. Rates of all types of cancer were higher than expected only for females in Beverly.

Looking at the breakdown of individual cancers that are tracked by the MA Cancer Registry, rates for the following cancers were elevated in one or more of the three target communities: bladder/urinary, brain/nervous system, breast, colon/rectum, esophagus, hodgkin lymphoma, kidney/renal pelvis, larynx, leukemia, lung/bronchus, melanoma of skin, multiple myeloma, non-hodgkin lymphoma, oral cavity/pharynx, pancreas, prostate, stomach, testis, and thyroid. (Data is included in Appendix 1d.) Cancers of the cervix, liver & intrahepatic bile ducts, ovary and uteri corpus/uterus were the only ones below the state standardized incidence ratio for all three communities.

Bronchus and Lung Cancer Statistics:

Bronchus and lung cancer are the most easily related to air pollution, therefore we reviewed incidence of lung cancer and lung cancer mortality further. The data shows:

Salem: The total incidence of lung cancer is significantly elevated for both males and females in all age groups over 45. Total deaths from lung cancer are also elevated for both males and females. (See Appendix 1d for more detailed breakout by population)

Beverly: Total incidence of lung cancer is elevated for females only in Beverly and the rates do not exceed state rates until ages 65 and older. The death rate from lung cancers is elevated for females only, with the exception of males over age 85. (See appendix for more detailed breakout by population)

Marblehead: Total incidence of lung cancer is not elevated. The rates do go up for one age group, females ages 75 to 84. Total death rates are not elevated, however, the rates are elevated for females ages 65 to 74, and males 75 and older. (See Appendix 1d for more detailed breakout by population)

Table 5: Bronchus and Lung Cancer Incidence – Total by Community

Total Bronchus & Lung Cancer Incidence	Area Age Adjusted Rate Males	Area Age Adjusted Rate Females	State Age- Adjusted Rate Males	State Age- Adjusted Rate Females
Salem	119.9	73.0	90.9	61.1
Beverly	89.4	76.1	90.9	61.1
Marblehead	64.0	53.8	90.9	61.1

Source: MA DPH MassCHIP Instant Topic: Bronchus and Lung Cancer Report (1998-2002 Cancer Registry). Yellow highlights represent those categories which are elevated above the existing State Age-Adjusted Rate

Table 6: Bronchus and Lung Cancer Mortality Report – Total by Community

Total Bronchus & Lung Cancer Deaths	Area Age- Adjusted Rate Males	Area Age- Adjusted Rate Females	State Age- Adjusted Rate Males	State Age-Adjusted Rate Females
Salem	78.3	55.7	70.7	45.7
Beverly	64.9	62.6	70.7	45.7
Marblehead	62.4	42.3	70.7	45.7

Source: MA DPH MassCHIP Instant Topic: Bronchus and Lung Cancer Report 2001-2003 Mortality (Vital Records) ICD-10 based. Yellow highlights represent those categories which are elevated above the existing State Age-Adjusted Rate.