The Collaborative on Health and the Environment – Washington

A Partnership Network for Environmental Health
Established and Coordinated by the Institute for Children's Environmental Health

Adult Cancer

This section of the clearinghouse contains information on overall cancer incidence rates as well as the five cancers with highest incidence rates that have “strong” or “good” evidence of links with environmental contaminants, according to the Collaborative on Health and the Environment’s "Toxicant and Disease Database": Breast (female), lung, melanoma, bladder, and non-Hodgkins lymphoma.

Other cancers with “strong” or “good” evidence of environmental causes include: bone, brain, cervical, esophageal, laryngeal, leukemia, liver, angiosarcoma, multiple myeloma, Hodgkins lymphoma, oral, pancreatic, renal (kidney), salivary gland, skin (non-melanoma), scrotal, and thyroid.

In 2005, the Collaborative on Health and the Environment released a report on the "Environmental and Occupational Causes of Cancer: A Review of Recent Scientific Literature".

Proportion of Adult Cancer Attributable to Environmental Contaminants

The proportion of cancers that can be attributed to environmental causes is controversial.

In 1981, Doll and Peto estimated that approximately 2% of cancer deaths were attributable to pollution, with a range of 1-5%. Doll updated this work in 1998, but produced similar findings. These estimates are now seen as being too conservative, and recently, the National Cancer Institute/National Institute for Environmental Health Science published a report on "Cancer and the Environment" which found that 2/3 of all cancers are caused by environmental factors, including lifestyle factors such as diet and exercise.

The recent World Health report on "Preventing Disease Through Healthy Environments: Towards an Estimate of the Environmental Burden of Disease 2006" estimated that 16% of cancers in men and 13% in women are due to the environment in the developed world, excluding lung cancer. These estimates do not include lifestyle factors.

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Summary of Information on Washington State

In 2004, cancer became the leading cause of death in Washington State. According to the Department of Health, which recently published its 2004 vital statistics, 10,968 people died from cancer, compared with 10,626 from heart disease.

From National Organizations:

The Centers for Disease Control and Prevention (CDC) has information on cancer death rates nationally and at a state level on their "Cancer Data" web page. This shows that the cancer death rate in Washington State in 2004 was 195.3 per 100,000 people, compared with a national rate of 199.8.

The CDC’s "2002 Incidence and Mortality" report contains information on incidence rates of different cancers for different ethnic and racial groups.

The National Cancer Institute’s "Surveillance, Epidemiology, and End-Results (SEER)" program provides information on cancer incidence, mortality and patient survival for several states or regions in the US, including Seattle-Puget Sound. The data available cover 1973-1989.

From State Organizations:

According to the Washington State Department of Health's "Comprehensive Cancer Control Plan (2004-2008)", cancer is the second leading cause of death and the leading cause of death among adults ages 45-74 years. Approximately one out of every four deaths each year in Washington State is due to cancer.

The Department of Health also coordinates the State "Cancer Registry" with information for each year between 1993-2003 currently available online or in hardcopy format. The online Cancer Registry allows researchers to look at cancer rates (mortality or incidence) for any year between 1994-2003, by county, gender, and race or ethnicity for a range of different types of cancer, with comparisons to national rates.

According to the "Cancer Registry Report for 2003", the five most common types of cancer reported among Washington residents are breast, prostate, lung, colorectal, and melanoma. The Report contains information on "Cancer by Site", for 24 different sites in the body. The age-adjusted incidence and death rates in Washington State for the five cancers with highest incidence rates that have “strong” or “good” evidence of links with environmental contaminants, according to the Collaborative on Health and the Environment’s "Toxicant and Disease Database are shown in the table below:

It also contains information on different types of cancer in different racial and ethnic groups, information on individual counties, and information on different types of cancer. The following table shows the information on the counties with the highest incidence rate for the five cancers that have “strong” or “good” evidence of links with environmental contaminants: breast (female), lung, melanoma, bladder, and non-Hodgkins lymphoma:

From Local Organizations:

We did not find any information sources on cancer from local organizations.

From Academic Institutions:

There are several studies on cancer in Washington State from academic institutions. However, many were relatively old and/or not relevant to environmental exposures.

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Information on Washington State in Context

The Centers for Disease Control and Prevention’s 2004 "Cancer Data Burden Factsheet for Washington State" states that the average annual age-adjusted death rate from cancer in Washington State is 195.3 per 100,000 and the national rate is 199.8.

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Quality of Information on Washington State

The information available on cancer in Washington State is very good, although there are some opportunities for improvement. The State's Cancer Registry was awarded an "A" by the Trust for America's Health, and is one of only 12 states in the nation to receive this rating. However, the Registry would be more helpful to researchers if it generated maps of cancer rates by county instead of simply listing all cancer rates per county.

Both the Department of Health’s Cancer Registry and National Cancer Institute offer cancer profiles on a county-by-county basis for Washington State, and the CDC offers cancer incidence rates for the more specific Seattle-Puget Sound region., however, there is a noticeable lack of cancer data from local organizations.

The DOH's Cancer Registry offers the most current information – from 2002 – on cancer in Washington State.

The National Cancer Institute’s "Surveillance, Epidemiology, and End-Results (SEER)" program provides information on cancer incidence, mortality and patient survival for several states or regions in the US, including Seattle-Puget Sound. The data available cover 1973-1989.

There is an overall need for more studies on different types of cancer in relation to exposures to carcinogenic chemicals in the environment.

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General Information Sources

Hardcopy Sources:

Doll R, and Peto R. (1981). The Causes of Cancer: Quantitative Estimates of Avoidable Risks of Cancer in the United States Today. Journal of the National Cancer Institute 66:1191-1308.

Doll R. (1998). Epidemiological Evidence of the Effects of Behavior and the Environment on the Risk of Human Cancer. Recent Results in Cancer Research 154:3-21.

Online Sources:

American Cancer Society: www.cancer.org/docroot/home/index.asp

Breast Cancer Fund: www.breastcancerfund.org

Center for Disease Control and Prevention: www.cdc.gov/

Collaborative for Health and the Environment: www.healthandenvironment.org/

Environmental Health Perspectives: ehp.niehs.nih.gov/

National Cancer Institute: www.cancer.gov/

Trust for America's Health: healthyamericans.org/

Washington State Department of Health: www.doh.wa.gov/

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