[Slide 1]

Evaluation of
Childhood Cancer Incidence in Sandwich, MA
1995-Present

Massachusetts Department of Public Health
Community Assessment Program

February 2006

[Slide 2]

Evaluation of Childhood Cancer Data
o	Calculate childhood cancer incidence rates for Sandwich and each of its four census tracts from 1995 – 2002
o	Review available data for childhood cancer incidents in Sandwich 2003 – 2005
o	Evaluate geographic patterns of childhood cancer in the town
o	Evaluate available childhood cancer risk factor information

[Slide 3]

Statistical Methods
o	Standardized Incidence Ratio (SIR)

SIR =	Observed # of cases	X 100	
	Expected # of cases		

o	95% Confidence Interval

[Slide 4]

Sandwich Map

[Slide 5]

Environmental Review
o	Review DEP data regarding public drinking water
o	Review location of groundwater plumes emanating from the Massachusetts Military Reservation (MMR)

[Slide 6]

Results – Childhood cancer incidence in Sandwich, MA: 1995-2002

 	Observed	Expected	SIR	95% CI	
Males	3	4.0	NC	NC	
Females	7	3.5	200	80-412	
Total	10	7.5	133	64-245	

[Slide 7]

Types of childhood cancer diagnosed from 1995-2002

Leukemia	3 children	
CNS Tumor	3 children	
Soft Tissue Sarcoma	2 children	
Lymphoma (Hodgkin’s Disease)	1 child	
Bone	1 child	

[Slide 8]

Types of childhood cancer diagnosed from 2003-2005

Leukemia	3 children	
CNS Tumor	2 children	
Bone	2 children	

[Slide 9]

Results – Childhood cancer incidence in Sandwich Census Tracts: 1995-2002

Census tracts	Total	Males	Females	
	OBS	EXP	SIR	95% CI	OBS	EXP	SIR	95% CI	OBS	EXP	SIR	95% CI	
0133	1	0.9	NC	NC	0	0.4	NC	NC	1	0.4	NC	NC	
0134	2	1.3	NC	NC	1	0.7	NC	NC	1	0.6	NC	NC	
0135	5	2.6	192	62-449	1	1.4	NC	NC	4	1.2	NC	NC	
0136	2	2.7	NC	NC	1	1.4	NC	NC	1	1.2	NC	NC	
Town	10	7.5	133	64-245	3	4.0	NC	NC	7	3.5	200	80-412	

[Slide 10]

Geographic Distribution 1995 - 2005
o	2 concentrations noted:
•	3 of the 6 children diagnosed with leukemia lived in southeast Sandwich (CT 0135) at the time of diagnosis 
•	2 children diagnosed with bone cancer lived in fairly close proximity to one another in southern Sandwich
o	No other atypical distribution patterns  were noted during the 1995-2005 time period

[Slide 11]

Conclusions
o	From 1995-2002, childhood cancer incidence was slightly elevated
•	This elevation was not statistically significant
o	From 1996-1999, 4 females residing in CT 0135 were diagnosed with cancer
•	2 were diagnosed with leukemia
•	1 diagnosis of bone cancer
•	1 diagnosis of a soft tissue sarcoma

[Slide 12]

Conclusions (cont’d)
o	From 2003-2005, 7 children were diagnosed with cancer
•	3 were diagnosed with leukemia
•	2 diagnoses of a CNS tumor
•	1 diagnoses of a bone cancer

[Slide 13]

Recommendations
o	Conduct interviews with biological mothers/fathers of children diagnosed with cancer in Sandwich from 1995-present
o	Review childhood cancer incidence in CTs adjacent to CT 0135 (i.e., CT 0131 in Barnstable and CT 0150 in Mashpee).
o	Review any additional environmental factors

[Slide 14]

Next Steps
o	Prepare and submit a 24A application to the MDPH Commissioner  (M.G.L. c. 111, §24A)
o	Receive approval
o	Contact parents by letter to request consent
o	Determine participation based on consent
o	Schedule and conduct interviews
o	Analyze results
o	Prepare summary of findings

[Slide 15]

Contact information
The full report is available on the MDPH website at http://www.mass.gov/dph/ceh.  

Staff in the Community Assessment Program can be reached at:
       Phone: (617) 624-5757
	Fax: (617) 624-5777