Cancer Surveillance and Outreach in Carlisle, Massachusetts: An Analysis of MDPH Cancer and Environmental Health Data in a Small Town Context

Introduction: The Carlisle Board of Health (BOH) sought to understand how cancer affects its town (population under 5,000), using data on expected and observed cancer incidence provided by the Massachusetts Cancer Registry (MCR). This project examined cancer incidence data summarized by city/town in five-year intervals, evaluated demographic and environmental factors that could contribute to cancer, and provided recommendations for cancer outreach. Methods: MCR city/town reports from 1995-2009 were examined to identify community cancer trends. A literature review focused on cancers of concern to guide outreach efforts. Data on contributing environmental exposures and health behaviors were explored to identify potential risk factors in Carlisle. Individual- and community-level recommendations were issued based on the data and literature. Results: Observed cases of breast cancer and melanoma in women and colorectal cancer and prostate cancer in men exceeded the number of expected cases. Bladder cancer in men and lung cancer in men and women were somewhat lower than expected. There was insufficient evidence of causation by local environmental exposure. Discussion: Excess cancer cases in Carlisle cannot be interpreted as a cancer cluster. Individuals should be aware of important risk factors and control lifestyle-related factors for common types of cancer. The BOH can monitor data on potential environmental exposures and provide ongoing communication with Carlisle residents about cancer in the community through social media, the local newspaper, and town events. Broad educational outreach on specific risk factors, including sun exposure, arsenic in drinking water, and youth tobacco use should be considered to foster healthy behaviors