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~it~ <br />.O <br />.M~. <br />3-~ <br />North Carolina Department of Health and Human Services <br />Division of Public Health • State Center for Health Statistics <br />1908 Mail Service Center • Raleigh, North Carolina 27699-1908 <br />Tel 919-733-4728 • Fax 919-733-8485 <br />Michael F Easley, Governor Carmen Hooker Odom, <br />>ecretary <br />Preliminary Evaluation of Cancer Cases <br />Mill Greek Area, Orange County, NC <br />Apri12006 ~ <br />North Carolina Central Cancer Registry <br />The Orange County Health Department contacted the North Carolina Central Cancer Registry (CCR) <br />with a community concern about possible elevated cancer incidence in the Mill Creek Area of Orange <br />County. The cancers of interest included lung and bronchus, liver, bladder and melanoma (skin) as <br />these are sometimes associated with environmental exposures. <br />Reporting of cancer cases to the Central Cancer Registry is required of all health care providers who <br />diagnose or treat cancer. Most reports are received from hospitals, but physicians whose practices <br />include cancer patients who are diagnosed and treated in their outpatient clinics also report cases. In <br />addition, the CCR links its data with death certificate files to be sure that all cancers identified on death <br />certificates are in the CCR database, <br />Years under study <br />This evaluation was restricted to the data collected since 1990 through 2003. 1990 was the earliest <br />year for which over 90 percent of the State's cases were reported to the CCR. Most of the cases that <br />are missed are those that are easily diagnosed and treated as outpatient cases, such as cases of <br />melanoma (skin) and prostate cancer. The CCR data are not yet complete for the years 2004 and <br />2005, so cases from these years were not included in the analysis. <br />Cluster Analysis Methods <br />When investigating clusters of cancer cases, several things are clues to likely associations with <br />exposures in the community. These include: <br />1. Groups of cases of all the same type of cancer (such as brain cancer or leukemia), Because <br />different types of cancer are caused by different things, cases of many different types of cancer <br />do not constitute a cluster of cases. <br />2. Groups of cases among children, or ones with an unusual age distribution. <br />3 Cases diagnosed during a relatively short time interval, Cases diagnosed over a span of years <br />do not constitute a cluster of cases unless there is consistency in the type of cancer. <br />~ The North Caxoluia Central Cancer Registry is part of the State Centex for I-Iealth Statistics, Chronic Disease and Injury Section, <br />Division of Public Health Questions about this report mn}' be directed to the Central Ganccr Registry at 919-715-4555_ <br />Page 35 of 47 <br />