1. Why was a study of cancer incidence conducted in Maynard?
  2. Were there specific concerns that prompted the request?
  3. What data were used in the study?
  4. How did the CAP evaluate cancer incidence in Maynard?
  5. How did the CAP review cancer patterns at the neighborhood level?
  6. What did the study find about the pattern of cancer in the Nick Lane neighborhood?
  7. Were there certain types of cancers diagnosed more frequently among residents of the Nick Lane neighborhood?
  8. Did the CAP find any unusual patterns of cancer in the Nick Lane neighborhood?
  9. What are the risk factors for breast cancer?
  10. Is there any other information related to risk factors for developing breast cancer that might help explain why the incidence might be higher in some parts of Maynard?
  11. What did the study find about the incidence of lung and bronchus cancer and cervical cancer in Maynard?
  12. What are the risk factors for lung and bronchus cancer?
  13. What are the risk factors for cervical cancer?
  14. How can I lower my risk of lung and bronchus cancer?
  15. How can I lower my risk of cervical cancer?
  16. Does MDPH plan to conduct further study in Maynard?
  17. Who should I contact for more information?

1. Why was a study of cancer incidence conducted in Maynard?
The Community Assessment Program (CAP) of the Massachusetts Department of Public Health, Bureau of Environmental Health Assessment (MDPH, BEHA) conducted an evaluation of cancer incidence in relation to environmental concerns at the request of Maynard residents and the Maynard Board of Health (BOH). Recent data from the Massachusetts Cancer Registry indicated townwide elevations in the incidence of lung and bronchus cancer and cervical cancer for the time period 1994-1998.

2. Were there specific concerns that prompted the request?
Specific concerns focused on resident reports of cancer diagnoses among residents in the Nick Lane neighborhood, located in the northwest part of the town, and whether these diagnoses may represent an atypical pattern or possibly be related to a common environmental factor.

3. What data were used in the study?
In order to study cancer incidence in a community, the CAP uses data from the Massachusetts Cancer Registry (MCR). The MCR collects information on cancer diagnoses among Massachusetts residents, not cancer deaths. The MCR has been monitoring cancer incidence in Massachusetts by law since 1982. The 17-year period 1982-1998 is the period for which the most recent and complete cancer incidence data were available at the time of this analysis.

4. How did the CAP evaluate cancer incidence in Maynard?
The CAP evaluated cancer incidence rates for lung and bronchus cancer and cervical cancer in Maynard as a whole for the 17-year time period 1982-1998 (i.e., the most recent and complete data available at the time of the request). Incidence rates for these two cancer types were also evaluated for three smaller time periods (i.e., 1982-1986, 1987-1992, and 1993-1998) to look for possible trends over time. In addition, because the MCR is a continual surveillance system for cancer, reports of residents of the Nick Lane neighborhood diagnosed with cancer (all types) since 1982 to the present time were also reviewed.

5. How did the CAP review cancer patterns at the neighborhood level?
In addition to calculating townwide cancer incidence rates for lung and bronchus cancer and cervical cancer, a qualitative evaluation of the patterns of these cancer types at a smaller geographic level (i.e., the neighborhood level) was conducted by mapping the address reported to the MCR for each person diagnosed with cancer between 1982-1998 to look for any possible concentrations of cases in any one area of Maynard.

The CAP also reviewed the pattern of cancer (of any type) in the Nick Lane neighborhood to determine whether any specific cancer type appeared to be concentrated in this area of Maynard. For confidentiality reasons, maps of the residence of individuals diagnosed with cancer cannot be included in the report.

6. What did the study find about the pattern of cancer in the Nick Lane neighborhood?
In general, our review found no atypical pattern of cancer in the Nick Lane neighborhood. From 1982-2002, there were a total of 21 different types of cancer reported among residents of this area. Because cancer is not one disease but a group of many different diseases caused by many different factors, this information does not indicate an atypical pattern of any one cancer type in this area.

7. Were there certain types of cancers diagnosed more frequently among residents of the Nick Lane neighborhood?
The most commonly reported diagnoses were consistent with those that occurred most often in both the state of Massachusetts as a whole and across the United States (i.e., cancers of the lung and bronchus, breast, prostate, and colon). The majority of cancer types diagnosed among residents of this area are predominantly associated with non-environmental risk factors such as family history, smoking, diet, and other lifestyle behaviors.

8. Did the CAP find any unusual patterns of cancer in the Nick Lane neighborhood?
Review of the geographic distribution of residents of the Nick Lane neighborhood diagnosed with cancer over the 21-year time period showed no specific pattern that would suggest a common factor (environmental or non-environmental) related to the incidence of cancer in the Nick Lane area played a primary role.

The pattern of breast cancer in the Nick Lane neighborhood, however, showed a slightly different trend with respect to known age patterns for this disease. Specifically, women in this area were, on average, slightly younger at the time of their breast cancer diagnoses than women diagnosed in the general population. However, review of specific information with regard to the different types of breast cancer (e.g., cell type, stage of disease, place of residence) did not indicate any other unusual patterns that might suggest a common risk factor related to place of residence in Maynard.

9. What are the risk factors for breast cancer?
No one knows the exact causes of breast cancer. A female's risk of breast cancer is higher if her mother, sister or daughter had breast cancer. Women who never have children or who have their first child after the age of 30 have a higher risk of breast cancer. Women who take hormone therapy for 5 or more years after menopause also appear to have an increased chance of developing this cancer type. Exposure to high levels of ionizing radiation, such as radiation therapy for previous cancers, also increases the risk of developing breast cancer. Other risk factors for breast cancer include personal history of benign breast disease and lifestyle factors such as diet, body weight, and lack of physical activity. Breast cancer risk is also associated with increased socioeconomic status. Socioeconomic differences in breast cancer risk may be a result of differences in screening for breast cancer as well as reproductive factors and individual lifestyle choices such as diet and physical activity.

Despite the large number of studies on causes of breast cancer, known factors are thought to account for less than half of all breast cancers. Researchers are continuing to examine potential risks for developing breast cancer, especially environmental factors.

10. Is there any other information related to risk factors for developing breast cancer that might help explain why the incidence might be higher in some parts of Maynard?
Information reviewed related to risk factors for developing breast cancer indicate that women in Maynard as a whole may have a higher prevalence of reproductive risk factors such as late age at first birth and low parity (i.e., number of children) compared to women in the state as a whole.

11. What did the study find about the incidence of lung and bronchus cancer and cervical cancer in Maynard?
Townwide incidence rates for these two cancer types were slightly elevated during the most recent time period evaluated (i.e., 1993-1998) as well as during the overall time period 1982-1998. In addition, the incidence of lung and bronchus cancer was statistically significantly elevated among males during 1993-1998. Review of available risk factor information indicates that 92% of Maynard residents diagnosed with lung and bronchus cancer reported being current or former smokers at the time of diagnosis, a known risk factor for this cancer type. There were no atypical patterns with respect to place of residence or diagnoses over time that would suggest common environmental factors played a primary role in the incidence of lung and bronchus cancer in Maynard.

12. What are the risk factors for lung and bronchus cancer?
The most important known risk factor for lung and bronchus cancer is cigarette smoking. In fact, it is estimated that more than 85% of all lung cancers are caused directly by smoking cigarettes and many of the rest are likely due to exposure to secondhand smoke. Other occupational and environmental risk factors, such as exposure to asbestos (a group of minerals that occur naturally as fibers and are used in certain industries) or long-term exposure to radon (an invisible, odorless, and tasteless radioactive gas that occurs naturally in soil and rocks), also increase the risk of developing lung and bronchus cancer.

13. What are the risk factors for cervical cancer?
The most important risk factor for cervical cancer is infection by the human papillomavirus (HPV), a sexually transmitted disease. Having sexual intercourse at a young age and having many sexual partners increase a female's risk of getting HPV. Smoking has also been suggested as a risk factor for cervical cancer. Females who smoke are about twice as likely as non-smokers to develop cervical cancer. Infection with the human immunodeficiency virus (HIV) also increases the risk of cervical cancer because HIV weakens a female's immune system so she is less able to fight both HPV and early cervical cancers. Environmental exposures are not thought to be associated with the development of cervical cancer.

14. How can I lower my risk of lung and bronchus cancer?
The best way to lower your risk of lung and bronchus cancer is to not use tobacco and to avoid secondhand smoke. Learn more about the presence of cancer-causing chemicals in your home and where you work and take steps to reduce or eliminate your chances of exposures. For example, testing your home for radon can show whether this substance is present. If so, different home renovations can be considered to lower radon levels.

15. How can I lower my risk of cervical cancer?
Women can generally reduce their risk for cervical cancer by avoiding infection with HPV and by having a regular pelvic exam and Pap test, which can detect abnormal cells before they become cancerous. Women who are or have been sexually active, or if they are age 18 or older, should have an annual Pap test. Since precancers and very early cervical cancers are nearly 100% curable, this test can prevent nearly all deaths from cervical cancer.

16. Does MDPH plan to conduct further study in Maynard?
The MDPH does not recommend further investigation of cancer incidence in the Nick Lane neighborhood of Maynard or in the town as a whole at this time.

17. Who should I contact for more information?

The Massachusetts Department of Public Health
Center for Environmental Health
Attn: Community Assessment Program
250 Washington Street, 7 th Floor
Boston, MA 02108

Phone: (617) 624-5757
Fax: (617) 624-5777


This information is provided by the Community Assessment Program within the Department of Public Health.