Tagging cancer by the zip code

Lee Dean Cox of Walterboro is a lung cancer survivor. During a routine physical in 1994, an X-ray revealed a nodule in her right lung.

The 62-year-old church organist, who said she never smoked, underwent major surgery to remove the tumor. Fifteen years later, she remains an advisor and source of comfort to others in her community who are diagnosed with lung cancer.

"It just seems in our area there is so much cancer," Cox said.

The South Carolina Central Cancer Registry was formed 15 years ago to track newly diagnosed cancers and cancer deaths. The project was a collaborative effort between S.C. Department of Health and Environmental Control and the Centers for Disease Control and Prevention.

The state registry is expected to release in April a 10-year report, cataloging cancer trends from 1996 to 2005, including survival data.

"While we often find more cancer, it's not necessarily statistically significant," registry director Susan Bolick-Aldrich said.

A cluster is a greater-than-expected number of cancers in a group of people in a geographic area over time, according to the CDC. But that alone does not constitute a cluster.

Given the common nature of some cancers, according to the CDC, clusters are more likely to involve a single type of cancer, a rare cancer or a cancer not usually found in a certain group, such as malignancies in children that are normally diagnosed in adults.

Since the state registry began, only one cancer cluster was detected, Bolick-Aldrich said.

In 1999, the registry reported a cluster in the Rosemont community in

North Charleston, where many developed cancer of the pleura, the lining between the lungs and rib cage.

Asbestos exposure often is related to this form of cancer. Of the 19 cases in the tri-county area in 1996-97, 12 were determined to have worked in the Charleston naval shipyard, the registry reported.

Registries and efforts to map cancer detected the band of high rates of mesothelioma along the East Coast that researchers attributed to asbestos exposure in the ship-building industry during the world wars.

While researchers have not classified Walterboro as a cluster, a study of cancer incidence and mortality showed that Cox is not imagining the trend.

Researchers found an unexpectedly high number of lung and prostate cancers in the zip code 29488 from 2000-04.

Statistically, 81.5 new cases of lung and bronchus cancer were expected, but 130 cases were diagnosed. During that period, 66 people were projected to die from the disease, yet 101 people succumbed.

When it came to prostate cancer, 109 men were diagnosed, 27 more than expected. And more than twice as many men, 27, died from the disease than the 12 projected.

Cox's family history mirrored the findings. Her brother had prostate cancer four years ago and then had a cancerous lobe of his lung removed, she said.

"The proportion of cancers caused by environmental factors, such as air pollution, is quite small," said Dr. Anthony Alberg, associate director for Cancer Prevention and Control at the Medical University of South Carolina's Hollings Cancer Center. "Those risks are much smaller than lifestyle factors."

The four most common cancers in the Unite States occur in the lung, colon, breast and prostate. Lifestyle and demographics can lead to higher rates of those diseases.

When it comes to lifestyle, smoking is a proven cause of lung cancer, and diet is tied to colon cancer risk. Also, drinking, weight and reproductive history have been linked to breast cancer, Alberg said.

A population's age can lead to higher rates since cancer tends to be a disease of older age. "Some of the nice coastal communities are popular retirement spots," Alberg said. "That's a high risk group. Cancer rates might become high for that reason alone."

Reach Jill Coley at 937-5719 or jcoley@postandcourier.com.