Cancer clusters: findings vs feelings.

The issue of cancer clusters, which has been in the spotlight recently, is plagued by a wide disparity between public perceptions and scientific findings. Movies like Erin Brockovich have led the public to think that industrial pollution in the environment is causing local "cancer clusters" where cancer cases are more prevalent due to cancer-causing chemicals. There are many scientifically documented instances in which chemical exposure has caused cancer in humans, but the evidence for purely environmental exposures causing cancer is sparse. The clusters that scientists have been able to attribute successfully to a particular cause have been occupational (such as workers in a factory developing a particular type of cancer from daily exposure to a specific chemical), linked to a particular medicine, or linked to behaviors such as smoking or sunbathing. There is some indication that chemicals dissolved in drinking water may elevate the risk of gastrointestinal and bladder/urinary tract cancers and that living next to a smelter or other "point source" of air pollution may elevate risk of lung cancer. The many efforts that have been made to demonstrate links between other types of cancer and environmental contamination have not conclusively identified such links. Several challenges bedevil any cancer cluster investigation and can result in ambiguous or misleading conclusions. This report discusses the potential cancer clusters in Toms River, New Jersey and Long Island, New York, because they contain many elements typical of cancer cluster investigations and have received considerable media attention.