{"id":16,"date":"2016-07-22T15:53:56","date_gmt":"2016-07-22T15:53:56","guid":{"rendered":"https:\/\/www.vdh.virginia.gov\/virginia-cancer-registry\/?page_id=16"},"modified":"2026-03-27T14:09:57","modified_gmt":"2026-03-27T18:09:57","slug":"cancer-clusters","status":"publish","type":"page","link":"https:\/\/www.vdh.virginia.gov\/virginia-cancer-registry\/cancer-clusters\/","title":{"rendered":"Cancer Cluster Information"},"content":{"rendered":"<div id=\"pl-16\"  class=\"panel-layout\" ><div id=\"pg-16-0\"  class=\"panel-grid panel-no-style\" ><div id=\"pgc-16-0-0\"  class=\"panel-grid-cell\" ><div id=\"panel-16-0-0-0\" class=\"so-panel widget widget_sow-editor panel-first-child\" data-index=\"0\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<p>Use the link below to submit a cancer cluster inquiry. We encourage you to please read our \u2018Virginia Cancer Registry Cancer Cluster Investigation Procedure' before submitting the form.<\/p>\n<\/div>\n<\/div><\/div><div id=\"panel-16-0-0-1\" class=\"so-panel widget widget_sow-button\" data-index=\"1\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-button so-widget-sow-button-flat-4ebd1646981a-16\"\n\t\t\t\n\t\t><div class=\"ow-button-base ow-button-align-center\"\n>\n\t\t\t<a\n\t\t\t\t\thref=\"https:\/\/redcap.vdh.virginia.gov\/redcap\/surveys\/?s=M4RA78PL3K\"\n\t\t\t\t\tclass=\"sowb-button ow-icon-placement-left ow-button-hover\" target=\"_blank\" rel=\"noopener noreferrer\" \t>\n\t\t<span>\n\t\t\t\n\t\t\tCancer Cluster Report Form\t\t<\/span>\n\t\t\t<\/a>\n\t<\/div>\n<\/div><\/div><div id=\"panel-16-0-0-2\" class=\"so-panel widget widget_sow-editor\" data-index=\"2\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<p>The following information <span class=\"NormalTextRun SCXW248425177 BCX8\">provides a background of cancer, cancer clusters, and <\/span><span class=\"NormalTextRun SCXW248425177 BCX8\">the cancer cluster<\/span><span class=\"NormalTextRun SCXW248425177 BCX8\"> investigation process. <\/span>Summaries of previous suspected cancer cluster inquiries can be found at the bottom of the page, or by <a href=\"#inv-reports\">clicking here<\/a>.<\/p>\n<\/div>\n<\/div><\/div><div id=\"panel-16-0-0-3\" class=\"so-panel widget widget_sow-editor panel-last-child\" data-index=\"3\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<h2><strong>What is cancer?<\/strong><\/h2>\n<p>\u201cCancer\u201d is one term that is used to refer to over one hundred different diseases. These diseases have in common an uncontrolled multiplication and growth of abnormal cells and the ability to spread to body parts that are distant from the original site. Cancers, as a group, are very common. Cancers are the second leading cause of death in the United States and Virginia, exceeded only by diseases of the heart and circulatory system. <span class=\"TextRun SCXW5290391 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW5290391 BCX0\" data-ccp-parastyle=\"Normal (Web)\">According to the American Cancer Society, one of every two men and one of every three women will be diagnosed with some form of cancer at some time in their lives.<\/span><\/span><\/p>\n<h2><strong>What causes cancers to form?<\/strong><\/h2>\n<p>Different cancers have different risk factors which promote their development. For example, cigarette smoking causes lung cancer, overexposure to the sun has been shown to be associated with the development of skin cancer, and lack of dietary fiber may be related to colorectal cancer. Other risk factors that have been identified include alcohol abuse, family history of cancer, age, sex, race, and some specific occupational exposures. Smoking, alcohol abuse, and poor diet account for 80% of the cancer deaths that occur.<\/p>\n<p>The degree to which environmental pollution causes cancer is not precisely known, but most experts agree that less than five percent of cancers are caused by pollution. Given that specific exposures are linked to specific types of cancer, if an environmental exposure caused cancer, its effects would be manifest in the occurrence of cases of the same type of cancer.<\/p>\n<h2><strong>How quickly does cancer develop?<\/strong><\/h2>\n<p>Cancers differ with respect to latency, or the time between exposure to one or more cancer-causing agents and the development of cancer. Generally speaking, however, cancers commonly take 10 to 30 years or more to develop to the point of being detectable. In\u00a0 children, the time from exposure to cancer development is shorter, 1-10 years. When looking for the cause of cancer, one must consider exposures that took place at least ten years before the cancer was diagnosed.<\/p>\n<h2><strong>What is a Cancer Cluster?<\/strong><\/h2>\n<p>A\u00a0<strong>cancer cluster<\/strong>\u00a0is defined as an<strong> \u201ca greater than expected number of the same or etiologically related cancer cases that occurs within a group of people in a geographic area over a defined period of time.\u201d<\/strong><\/p>\n<p>To be a cancer cluster, a group of cancer cases must meet the following criteria. Until all of these parameters are met, the group of cancer cases is often referred to as a <strong>suspected cancer cluster.<\/strong><\/p>\n<ul>\n<li><strong>A greater than expected number:<\/strong> When the number of observed cases is greater than typically observed in a similar setting.<\/li>\n<li><strong>Of the same or etiologically related cancer cases:<\/strong> Cases are of the same type, are within a family of tumors (e.g., Ewing\u2019s family of tumors), or have a known or suggested link to the same specific environmental or chemical exposures. It is possible to consider multiple cancer types when such a known exposure (e.g., radiation or a specific chemical) is linked to more than one cancer type or when more than one contaminant or exposure type has been identified.<\/li>\n<li><strong>Within a group of people:<\/strong> The population in which the cancer cases are occurring is defined by its demographic factors (e.g., race, ethnicity, age, and sex).<\/li>\n<li><strong>In a geographic area:<\/strong> The geographic area may be based upon pre-existing geopolitical boundaries (e.g., census tract, county, or ZIP code\/ZIP code tabulation area). It may be defined according to the nature and extent of potential exposures that may cross multiple or partial boundaries. These geographic boundaries are used to determine the number of cancer cases as they relate to the total population in this predefined area. It is possible to create or obscure a cluster inadvertently by modifying the area of interest.<\/li>\n<li><strong>Over a period of time: <\/strong>The time frame used to establish the beginning and end dates for analysis. The time period chosen for analysis will affect both the total cases observed and the calculation of the expected incidence of cancer in the population.<\/li>\n<\/ul>\n<h2><strong>Are cancer clusters common?<\/strong><\/h2>\n<p>No, real cancer clusters where a cause can be identified are extremely rare. There have been no proven cancer clusters in Virginia, and only a few around the United States. In a scientific review of over 500 cancer cluster investigations done over 20 years, only about 1 in 8 found a true increase in cancer rates, and in only one case was a clear cause for the increase found.<\/p>\n<h2><strong>There are five people on my street with cancer; is this a meaningful cluster?<\/strong><\/h2>\n<p>Not necessarily. Cancer is very common, especially among older people, and each type of cancer may have a different cause. By chance, a group of people on your block could have a number of different cancers, but it may not be a meaningful cluster.<\/p>\n<h2><strong>How are cancer clusters investigated?<\/strong><\/h2>\n<p>When a suspected cancer cluster is reported, staff from the Virginia Cancer Registry will first review the initial information provided to confirm the correct type of cancer, where the cancer started within the patient, and when it was diagnosed. This step also includes reviewing doctors\u2019 notes and test results to ensure accuracy. Once geography of interest, population, and time frame are defined, an epidemiologist compares the cancer rates to Virginia or another comparable geography. The VCR also collaborates with the Environmental Public Health Tracking (EPHT) Program and Public Health Toxicology Program to address environmental concerns when needed.<\/p>\n<p>Based on this initial investigation, most suspected clusters can be determined not to be true clusters, and no further investigation is needed. Only when data point to an indication of a cluster or unusual pattern of cancer would an in-depth investigation may occur, to include technical assistance from the CDC and\/or the Agency for Toxic Substances and Disease Registry (ATSDR). According to guidelines from the CDC, some factors that do not support the need for further investigation include:<\/p>\n<ul>\n<li>Cancer cases within family members who are blood relatives (especially cancers known to be strongly genetically linked).<\/li>\n<li>Different types of cancers that are not known to be related to one another.<\/li>\n<li>A few cases of very common cancers, particularly when the people affected are of the usual age and sex for those cancers.<\/li>\n<li>Cancers among people who didn\u2019t live in the same area at the time an exposure would have to had taken place to cause that cancer.<\/li>\n<\/ul>\n<h2><strong>What are the possible outcomes of a cluster investigation?<\/strong><\/h2>\n<p>There are three possible outcomes from a cancer cluster investigation:<\/p>\n<ul>\n<li>In most cases, an investigation will show that the suspected cluster is not a true cancer cluster.<\/li>\n<li>Less often, an investigation finds a true cancer cluster, but no cause can be found.<\/li>\n<li>Rarely, an investigation finds a true cancer cluster with a cause or no cause.<\/li>\n<\/ul>\n<h2><strong>Cancer Prevention <\/strong><\/h2>\n<p>Not all cancer can be prevented, but the best way to minimize your risk is to avoid factors known to be related to cancer and to participate in routine screening programs in order to catch cancer in early stages, which increases the chances of a favorable outcome. Examples of these examinations include rectal examinations, Pap tests, breast self-examinations, and mammography. Further, the EPA recommends all homes be tested for radon, regardless of geographic location or the zone designation of the county in which they are located. For more information and resources, visit <a href=\"https:\/\/www.vdh.virginia.gov\/cancer\/\">https:\/\/www.vdh.virginia.gov\/cancer\/<\/a>.<\/p>\n<h2><strong>More information on Cancer Clusters<\/strong><\/h2>\n<p><a href=\"https:\/\/www.cdc.gov\/cancer-environment\/about\/index.html\">Centers for Disease Control and Prevention information on\u00a0cancer clusters\u00a0and\u00a0Cancer Clusters FAQ.<\/a><\/p>\n<p><a href=\"https:\/\/statecancerprofiles.cancer.gov\/map\/\">National and State Cancer Data and Interactive Map from the National Cancer Institute<\/a><\/p>\n<p><a href=\"http:\/\/www.cancer.gov\/cancertopics\/factsheet\/risk\/clusters\">National Cancer Institute information on cancer clusters<\/a><\/p>\n<p><a href=\"https:\/\/www.cancer.org\/cancer\/risk-prevention\/understanding-cancer-risk\/cancer-clusters.html\">American Cancer Society information on cancer clusters<\/a><\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><div id=\"pg-16-1\"  class=\"panel-grid panel-no-style\" ><div id=\"pgc-16-1-0\"  class=\"panel-grid-cell\" ><div id=\"panel-16-1-0-0\" class=\"so-panel widget widget_sow-accordion panel-first-child panel-last-child\" data-index=\"4\" ><div id=\"inv-reports\" class=\"panel-widget-style panel-widget-style-for-16-1-0-0\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-accordion so-widget-sow-accordion-default-37a5456e788c-16\"\n\t\t\t\n\t\t><div>\n\t<div class=\"sow-accordion\">\n\t\t\t<div class=\"sow-accordion-panel\n\t\t sow-accordion-panel-open\t\t\t\"\n\t\t\t\tdata-anchor-id=\"suspected-cancer-cluster-investigation-summaries\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header-container\" role=\"heading\" aria-level=\"2\">\n\t\t\t\t\t<div class=\"sow-accordion-panel-header\" tabindex=\"0\" role=\"button\" id=\"accordion-label-suspected-cancer-cluster-investigation-summaries\" aria-controls=\"accordion-content-suspected-cancer-cluster-investigation-summaries\" aria-expanded=\"true\">\n\t\t\t\t\t\t<div class=\"sow-accordion-title sow-accordion-title-icon-left\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tSuspected Cancer Cluster Investigation Summaries\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"sow-accordion-open-close-button\">\n\t\t\t\t\t\t\t<div class=\"sow-accordion-open-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf218;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"sow-accordion-close-button\">\n\t\t\t\t\t\t\t\t<span class=\"sow-icon-ionicons\" data-sow-icon=\"&#xf209;\"\n\t\t \n\t\taria-hidden=\"true\"><\/span>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t<div\n\t\t\t\tclass=\"sow-accordion-panel-content\"\n\t\t\t\trole=\"region\"\n\t\t\t\taria-labelledby=\"accordion-label-suspected-cancer-cluster-investigation-summaries\"\n\t\t\t\tid=\"accordion-content-suspected-cancer-cluster-investigation-summaries\"\n\t\t\t\t\t\t\t>\n\t\t\t\t<div class=\"sow-accordion-panel-border\">\n\t\t\t\t\t<p><span style=\"text-decoration: underline;\">2025 Investigations<\/span><\/p>\n<ul>\n<li><strong>Requested:<\/strong> July 2025, Lenowisco Health District, Scott County community<br \/>\n<strong>Geographic Area:<\/strong> Scott County<br \/>\n<strong>Cancer Types:<\/strong> Pediatric cancers--bone and joints, leukemia, non-Hodgkin's lymphoma, thyroid, testicular, other endocrine including thymus<strong>What was done:<\/strong> A Standardized Incidence Ratio (SIR) was calculated for each pediatric cancer type in Scott County compared with Virginia for 2014-2023. The Fisher's Exact Test was also performed due to small numbers. Both tests suggested that pediatric cancer rates in Scott County between 2014-2023 did not differ significantly from those observed statewide. Environmental concerns related to drinking water, radon, and industrial sites were explored, and no pattern for a shared environmental exposure was identified. A full report can be found by <a href=\"https:\/\/www.vdh.virginia.gov\/content\/uploads\/sites\/71\/Scott-County-Cluster-Report-2014-2023.pdf\" target=\"_blank\" rel=\"noopener\">clicking here<\/a>, along with an <a href=\"https:\/\/www.vdh.virginia.gov\/content\/uploads\/sites\/71\/Executive-Summary_Scott-County.pdf\" target=\"_blank\" rel=\"noopener\">executive summary<\/a> with resources, and a <a href=\"https:\/\/www.vdh.virginia.gov\/content\/uploads\/sites\/71\/FAQs-for-Scott-County-Investigation.pdf\" target=\"_blank\" rel=\"noopener\">FAQ document<\/a> summarizing the findings.\n<p><strong>Outcome:<\/strong> Monitoring of 2024 and 2025 cases when data are complete. No cluster detected for 2014-2023, no further action indicated.<\/p><\/li>\n<\/ul>\n<ul>\n<li><strong>Requested:<\/strong> February 2025, by an individual<br \/>\n<strong>Geographic Area:<\/strong> Alleghany Health District (Craig, Botetourt, Roanoke Counties)<br \/>\n<strong>Cancer Types:<\/strong> Brain and other Central Nervous System cancers<strong>What was done:<\/strong> Age-adjusted incidence rates were calculated for Brain and other CNS cancers in Alleghany Health District for age groups 40+ and 50+, compared with Virginia for 2017-2021. A Standardized Incidence Ratio was calculated for ten year age groups (40-49, 50-59, 60-69, 70+). The SIR suggested that Brain or Other CNS cancers in Alleghany Health District between 2017-2021 did not differ significantly from those observed statewide. A summary report was provided to the requestor.\n<p><strong>Outcome:<\/strong> No cluster detected, no further action indicated.<\/p><\/li>\n<\/ul>\n<p><span style=\"text-decoration: underline;\">2024 Investigations<\/span><\/p>\n<ul>\n<li><strong>Requested:<\/strong> January 2024, by an individual<br \/>\n<strong>Geographic Area:<\/strong> Salem, VA (Roanoke College)<br \/>\n<strong>Cancer Types:<\/strong> Breast, Colorectal, non-Hodgkin's lymphoma, leukemia<br \/>\n<strong><br \/>\nWhat was done:<\/strong> A Standardized Incidence Ratio was calculated for each cancer type in Salem City, where Roanoke College is situated, compared with Roanoke County and Virginia for 2011-2020.\u00a0 The SIR suggested that cancer rates for each type in Salem City between 2011-2020 did not differ significantly from those observed in Roanoke County and statewide. Salem City cancer rates were also examined for individual years during the period of 2011\u20132020, and no obvious increase in trend suggesting an unusual pattern of cancer was observed. A summary report was provided to the requestor.<strong>Outcome:<\/strong> No cluster detected, no further action indicated.<\/li>\n<\/ul>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>Use the link below to submit a cancer cluster inquiry. We encourage you to please read our \u2018Virginia Cancer Registry Cancer Cluster Investigation Procedure&#8217; before submitting the form. The following information provides a background of cancer, cancer clusters, and the cancer cluster investigation process. Summaries of previous suspected cancer cluster inquiries can be found at [&hellip;]<\/p>\n","protected":false},"author":657,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_lmt_disableupdate":"no","_lmt_disable":"","footnotes":""},"tags":[],"class_list":["post-16","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Cancer Cluster Information - Virginia Cancer Registry<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.vdh.virginia.gov\/virginia-cancer-registry\/cancer-clusters\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cancer Cluster Information - Virginia Cancer Registry\" \/>\n<meta property=\"og:description\" content=\"Use the link below to submit a cancer cluster inquiry. We encourage you to please read our \u2018Virginia Cancer Registry Cancer Cluster Investigation Procedure&#039; before submitting the form. The following information provides a background of cancer, cancer clusters, and the cancer cluster investigation process. 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We encourage you to please read our \u2018Virginia Cancer Registry Cancer Cluster Investigation Procedure' before submitting the form. The following information provides a background of cancer, cancer clusters, and the cancer cluster investigation process. 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