The Dover township childhood cancer investigation

In 1995 the New Jersey Department of Health and Senior Services (DHSS) determined that the incidence of childhood cancer--specifically, brain and central nervous system cancer in children under the age of five--in a New Jersey community was significantly higher than expected. This finding, which confirmed public perceptions, as well as the location within the community of two Superfund sites generated a comprehensive undertaking by state and federal agencies to account for the observation and to determine possible etiologies. Beginning in 1997 the DHSS designed and conducted an epidemiologic study primarily for the purpose of identifying possible disease risk factors that might have led to the increased cancer incidence. In December 1999 the agency released an interim report of its findings. Although the interim report did not identify significant differences in potential exposures between cancer cases and appropriately chosen control groups, the DHSS cautions that the study remains incomplete and no conclusions should be drawn at this time. Other factors, including the source of the drinking water, residential proximity to hazardous sites, parental occupation, and purported exposure to sources of air pollution remain to be analyzed. The final report is due by the end of 2001. New Jersey Medicine associate editors Leah Ziskin, MD, and Alan Lippman, MD, met with James Blumenstock, MA, senior assistant commissioner; Jerald Fagliano, PhD, program manager; and Eddy Bresnitz, MD, assistant commissioner and state epidemiologist at DHSS. The following interview seeks to understand the motivation behind this comprehensive study and the methodologies that are used to evaluate a cancer cluster.