{"id":16372,"date":"2022-07-21T11:06:34","date_gmt":"2022-07-21T15:06:34","guid":{"rendered":"https:\/\/geiselmed.dartmouth.edu\/news\/?p=16372"},"modified":"2022-07-21T11:06:34","modified_gmt":"2022-07-21T15:06:34","slug":"new-hampshire-and-northeast-u-s-regions-high-childhood-cancer-rates-re-examined","status":"publish","type":"post","link":"https:\/\/geiselmed.dartmouth.edu\/news\/2022\/new-hampshire-and-northeast-u-s-regions-high-childhood-cancer-rates-re-examined\/","title":{"rendered":"New Hampshire and Northeast U.S. Region\u2019s High Childhood Cancer Rates Re-Examined"},"content":{"rendered":"<figure id=\"attachment_16375\" aria-describedby=\"caption-attachment-16375\" style=\"width: 1920px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2022\/07\/JudyRees_Insider.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-16375 size-full\" src=\"https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2022\/07\/JudyRees_Insider.jpg\" alt=\"\" width=\"1920\" height=\"1080\" srcset=\"https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2022\/07\/JudyRees_Insider.jpg 1920w, https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2022\/07\/JudyRees_Insider-230x130.jpg 230w, https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2022\/07\/JudyRees_Insider-640x360.jpg 640w, https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2022\/07\/JudyRees_Insider-98x55.jpg 98w, https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2022\/07\/JudyRees_Insider-1536x864.jpg 1536w, https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2022\/07\/JudyRees_Insider-1600x900.jpg 1600w, https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2022\/07\/JudyRees_Insider-800x450.jpg 800w, https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2022\/07\/JudyRees_Insider-270x152.jpg 270w, https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2022\/07\/JudyRees_Insider-580x326.jpg 580w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\" \/><\/a><figcaption id=\"caption-attachment-16375\" class=\"wp-caption-text\">Dartmouth Cancer Center pediatric oncologist, Julie Kim, MD, PhD, is involved in investigation into why the Northeast region of the U.S. has the highest pediatric cancer rates.<\/figcaption><\/figure>\n<p>In 2018, a <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29953430\/\">paper<\/a> by David A. Siegel, MD, MPH, of the Centers for Disease Control and Prevention (CDC) made headlines in New Hampshire. The paper reported that the state of New Hampshire and the Northeast region of the U.S. have some of the highest incidence rates of pediatric cancer (age 0-19) in the country.\u00a0But the report was a descriptive study, and the claims about New Hampshire cancer rates did not take important factors such as race or ethnicity into account.<\/p>\n<p>\u201cPediatric cancer rates are known to be highest in white children than other racial\/ethnic subgroups, so we would expect populations with more minorities to have lower rates, which, in part, led us to re-examine the previous report,\u201d says <strong>Judy R. Rees,<\/strong> BM, BCh, MPH, PhD, a cancer population scientist at Dartmouth Cancer Center who specializes in studying cancer data.<\/p>\n<p>Using the Cancer in North America (CiNA) analytical file \u2013 the same data used by Dr. Siegel \u2013 Rees\u2019 team examined rates overall, as well as by race and ethnicity, and statistically tested whether New Hampshire really is an outlier, or whether the broader Northeast region (Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania Rhode Island, and Vermont) has a higher incidence of pediatric cancer than the rest of the country.<\/p>\n<p>The study reveals that the Northeast does have a statistically significantly higher incidence of cancer compared to all other U.S. regions (i.e., Midwest, South, West), but within the Northeastern states, no single state is an outlier.<\/p>\n<p>\u201cNew Hampshire was previously cited as the state with the highest pediatric cancer incidence rate, but in fact New Hampshire is not statistically distinguishable from other states within the Northeast, both overall and when stratified by race,\u201d confirms Rees.<\/p>\n<p>These findings, \u201c<a href=\"https:\/\/aacrjournals.org\/cebp\/article-abstract\/doi\/10.1158\/1055-9965.EPI-22-0317\/707118\/Pediatric-Cancer-by-Race-Ethnicity-and-Region-in?redirectedFrom=fulltext\">Pediatric Cancer by Race, Ethnicity and Region in the United States<\/a>\u201d are newly published in <em>Cancer Epidemiology, Biomarkers and Prevention, a journal of the <\/em>American Association for Cancer Research<em>. <\/em><\/p>\n<p>Variations in the incidence of pediatric cancer and cancer subtypes in children of different races were also examined in the study. The age-standardized incidence rates vary by more than 38% across racial groups, with lowest rates in non-Hispanic Black children (144.8 per million per year) and highest in non-Hispanic White children (201.8 per million per year). This means consideration of race and ethnicity is critical when comparing different states and regions.<\/p>\n<p>\u201cWe see big differences in cancer types by race\/ethnicity and region. In particular, the higher incidence of certain cancer types in the Northeast compared to the U.S. were not mirrored in the Hispanic population,\u201d says Rees, who notes the importance of trying to understand the risk factors at play in the Northeast, and the reasons why some subgroups, such as Hispanic, and American Indian\/Alaska Native children, may have different patterns of risk.<\/p>\n<p>\u201cBased on our work, I think the most important questions now are, why does the Northeast have the highest childhood cancer rates in the country, and is there something we as a region can do about it?\u201d<\/p>\n<p>Underlying reasons, even after stratifying by race, are likely multifactorial. In 2019, New Hampshire invested legislative funds to explore childhood cancer issues in the Granite State, led by the NH State Cancer Registry team. This funding allowed a group of cross-disciplinary childhood cancer and environmental health experts to review the evidence on childhood cancer risk factors, including maternal age at delivery, socioeconomic factors, and a host of other possible explanations such as environmental chemical and radiation exposure, parental smoking and use of recreational drugs and alcohol, and more.<\/p>\n<p>As regional differences in pediatric cancer incidence are explored, Rees emphasizes the value of ongoing collaborations between Northeastern states\u2019 health departments and epidemiologists as experts seek to understand the causes and possible solutions.<\/p>\n<p><strong>Judy R. Rees,<\/strong> <strong>BM, BCh, MPH, PhD,<\/strong> is a Member of the Cancer Population Sciences Research Program at Dartmouth Cancer Center, and Associate Professor of Epidemiology and of Community and Family Medicine at Dartmouth\u2019s Geisel School of Medicine. Her research interests include cancer epidemiology, and the development of approaches to reduce the burden of cancer in the community.<\/p>\n<p><strong>About Dartmouth Cancer Center<\/strong><\/p>\n<p><a href=\"http:\/\/cancer.dartmouth.edu\/\">Dartmouth Cancer Center<\/a> combines the advanced cancer research at the\u00a0<a href=\"https:\/\/geiselmed.dartmouth.edu\/\">Geisel School of Medicine at Dartmouth<\/a>, with award-winning, personalized, and compassionate patient-centered cancer care based at the Norris Cotton Cancer Care Pavilion at <a href=\"https:\/\/www.dartmouth-hitchcock.org\">Dartmouth Hitchcock Medical Center<\/a>. With 14 locations around New Hampshire and Vermont, Dartmouth Cancer Center is one of only 52 National Cancer Institute-designated Comprehensive Cancer Centers. Each year the Dartmouth Cancer Center schedules 74,000 appointments seeing more than 4,500 newly diagnosed patients, and currently offers patients more than 240 active clinical trials. Celebrating its 50<sup>th<\/sup> anniversary in 2022, Dartmouth Cancer Center remains committed to excellence, outreach and education. We strive to prevent and cure cancer, enhance survivorship and to promote cancer health equity through pioneering interdisciplinary research and collaborations. Learn more at <a href=\"http:\/\/cancer.dartmouth.edu\">http:\/\/cancer.dartmouth.edu<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>New study from Dartmouth Cancer Center re-examines claims of high pediatric cancer rates in New Hampshire to show that no single state in the Northeast is an outlier when taking important factors into consideration. <\/p>\n","protected":false},"author":143,"featured_media":16374,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[1071],"class_list":["post-16372","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","tag-dartmouth-cancer-center","author-143"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2022\/07\/JudyRees_featured.jpg","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p4r3h1-4g4","_links":{"self":[{"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/posts\/16372","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/users\/143"}],"replies":[{"embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/comments?post=16372"}],"version-history":[{"count":3,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/posts\/16372\/revisions"}],"predecessor-version":[{"id":16377,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/posts\/16372\/revisions\/16377"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/media\/16374"}],"wp:attachment":[{"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/media?parent=16372"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/categories?post=16372"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/tags?post=16372"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}