Breast Cancer Rates 'Disturb'

Breast cancer rates on the South Fork and in Riverhead among women 54 and under indicate the disease is significantly more prevalent in those areas than in the rest of Suffolk County, according to a new study by the Suffolk County Department of Health Services.

The study, its findings released last week, followed an analysis done by the Brookhaven National Laboratory Environmental Task Force, which found a disproportionate incidence of breast cancer on the East End.

The findings of the County Health Department's study were made public at a press conference in Hauppauge last Thursday at which Suffolk Executive Robert J. Gaffney said that what is next needed is a yet "more detailed follow-up to the results" of the B.N.L. Environmental Task Force report.

Age-Specific Survey

In opening the press conference, Mr. Gaffney reviewed the task force report's findings that the number of "incidents of breast cancer on the East End appeared significantly higher than the rest of the county. This information prompted another survey, this time by the County Health Department."

Using data obtained from the New York State Breast Cancer Registry for the period between 1989 and 1993, the Health Department divided its survey into three specific areas, the North Fork, the South Fork, and Riverhead. "Furthermore," Mr. Gaffney said, "they made the survey age-specific. In other words, they would group breast cancer victims by age: 54 and under, 55 to 64, and 65 and over."

Disturbing Numbers

"The overall results showed that for the entire East End there were 78.8 cases of breast cancer per 100,000 of population in the 54 and under category. The average for the rest of the county was 56.4 cases per 100,000. The rates among age groups 55 to 64 and 65 and over were consistent with the rest of the county. However, in the 54 and under group, the numbers were disturbing."

"The geographical breakdown showed that, in the 54 and under category, the North Fork's incident rate was nearly identical to the rest of the county. However, the Riverhead and South Fork rate was considerably higher," Mr. Gaffney continued. "The Riverhead incident rate was 78.2 per 100,000 population, while on the South Fork the rate was 90.3 per 100,000."

"Percentage-wise, the South Fork had an elevation in cases some 60 percent higher than the rest of the county," said Mr. Gaffney.

More Research

"Now, I have to emphasize at this time that it is far too early to draw any conclusions from these findings," said Mr. Gaffney. He then spoke of the "more in-depth" research that he believes is necessary. This would include asking the state for up-to-date statistics on Suffolk breast cancer rates.

Further, said Mr. Gaffney, "we'll be contacting victims of breast cancer and trying to piece together any particular or unusual patterns. We'll be contrasting those findings to information received from persons not stricken with the disease."

The authors of the epidemiological analysis - Dr. Roger Grimson, chairman of the task force and a biostatistician at the State University at Stony Brook, and a Shirley librarian, Dawn Triche - say in it that the East End breast cancer rate is "not attributable" to B.N.L.

Geographic Breakdown

The executive summary of the report, which was issued on Jan. 26, declares that "geographic patterns" were studied "of the following cancers: thyroid, leukemia, non-Hodgkin's lymphoma, brain and nervous system, female breast, prostate, liver, bone, multiple myeloma, and childhood rhabdomyosarcoma. . . . The decisions regarding the kinds of cancers and malformations to investigate were reached with the assistance of medical and environmental consultants on the basis of the potential for environmental causes and feasibility."

"A circle of a 15-mile radius was inscribed around B.N.L.," the summary continues. The circle was then partitioned into four regions "oriented in north, south, east, and west directions in order to have optimal concordance with predominant groundwater plume directions - south - and wind directions - east."

Unexpected Finding

"The conclusions of the epidemiological study are that (1) cancer rates of all types of cancer studies are not elevated near B.N.L. and (2) there is no evidence that rates among the four sectors are significantly different from each other or are correlated with underground plume or wind directions. Also, there is no evidence that childhood rhabdomyosarcoma incidence is elevated in Suffolk County or in the circle encompassing B.N.L."

"An unexpected finding," the summary goes on, "is that the age-adjusted female breast cancer rate on the 'East End' of Long Island is significantly elevated - 129 per 100,000 women - compared with rates of other areas, e.g., the Nassau County rate of 117 per 100,000 and the New York State rate of 106 per 100,000. This elevated East End rate is not attributable to B.N.L. for reasons discussed in this report."

There are four reasons provided subsequently in the body of the analysis.

Health Care Access

The report states, "Although environmental problems can contribute to elevated cancer rates, some demographic or population dynamic factors that also can lead to high rates could at least partially explain the high rate for the East End."

"First, in general, increases in mammography utilization lead to early diagnoses, grouping what would be later cases into an earlier time period . . . . This would cause a temporary - few years - increase in breast cancer rates, followed by a leveling off or a slight drop in rates. . . ."

"Possibly, access to health care is more restricted on the East End than in the other more densely populated regions of Suffolk County. If that is the case then visits to health care facilities for mammography for early detection of breast cancer would occur less frequently among women residing in this region."

More Possibilities

"Second, it has been observed that breast cancer rates are higher in more affluent geographic regions." But although the summary noted that some wealthy individuals reside on the East End, the median income levels in 1980 and 1990 were lower here than in other parts of the county. "Therefore, it is unlikely that any risk factors which coincide with affluence have elevated the East End breast cancer rates."

"Third, the calculated cancer rate could be inflated by either an overcount of cases and/or an undercount of the population at risk."

"Fourth, the possibility exists that large proportions of women moving to the East End during the past 10 or so years possess known nonenvironmental factors that modify breast cancer risk, such as affluence, genetic risk profiles, personal or familial histories of cancer, and certain reproductive characteristics. A region with an influx of large numbers of women who can be identified with some of these factors will experience increased breast cancer rates," the report states.

Conflict Denied

The vice chairman of the task force, Ronald Stanchfield, disputes that, associating the high rate of East End cancer incidents to a "synergy" involving B.N.L. radioactive emissions, the use of agricultural pesticides here, and radioactive releases from the Millstone nuclear plants. Mr. Stanchfield, of East Hampton, also disputes the finding of no concentration of breast or other cancers near B.N.L.

Mr. Stanchfield says that Dr. Grimson's having been a consultant to B.N.L. and his department at the State University at Stony Brook now having contracts with B.N.L. establishes an "enormous conflict of interest." Mr. Stanchfield was an inspector-turned-whistleblower on the Shoreham nuclear plant project and is now a builder.

Dr. Grimson has emphatically denied any conflict of interest.

Mona Rowe, a public relations person at Brookhaven, said, "Dr. Grimson is a very credible person. He does very good work." She also emphasized that Ms. Triche worked on the epidemiological report with Dr. Grimson. "These are two individuals. And what is speaking is the data."