OVERVIEW
GIS-H:
A NEW RESEARCH TOOL
OVERVIEW
The
Long Island Breast Cancer Study Project (LIBCSP) is a multistudy
effort to investigate whether environmental factors are responsible
for breast cancer in Suffolk, Nassau, and Schoharie counties, N.Y.,
and in Tolland County, Conn. The investigation began in 1993 under
Public Law 103-43 and is funded and coordinated by the National
Cancer Institute (NCI), in collaboration with the National Institute
of Environmental Health Sciences (NIEHS). The LIBCSP is part of
the overall research approach of the National Institutes of Health
(NIH), of which NCI and NIEHS are a part, to investigate the causes
of breast cancer and find ways to prevent the disease.
The
LIBCSP consists of more than 10 studies that include human population
(epidemiologic) studies, the establishment of a family breast and
ovarian cancer registry, and laboratory research on mechanisms of
action and susceptibility in development of breast cancer. Most
of the studies are conducted by scientists at major medical research
institutions in the Northeast. Altogether, at least $27 million
is being spent for research from 1993 through 2000 at these institutions.
Breast
Cancer and the Environment
The
cornerstone of the LIBCSP is a population-based, case-control study,
entitled Breast Cancer and the Environment on Long Island, that
is being conducted to determine if certain environmental contaminants
increase risk of breast cancer. The study focuses on investigating
whether the pesticides DDT, chlordane, dieldrin, and polycylic aromatic
hydrocarbons (PAH), a ubiquitous pollutant caused by incomplete
combustion of various chemicals including diesel fuel and cigarette
smoke, are associated with increased risk for breast cancer. The
study is being led by Marilie Gammon, Ph.D., of the University of
North Carolina at Chapel Hill, N.C., and formerly of Columbia University,
New York City, where the study was launched.
All
women in Nassau and Suffolk counties who were newly diagnosed with
breast cancer during a one-year period that ended mid-1997 (cases)
were eligible to participate in the study. A comparison group (controls)
of women who did not have breast cancer were randomly selected from
the two counties. About 1,500 cases and 1,500 controls are participating.
(Dr. Gammon relocated to the University of North Carolina at Chapel
Hill in mid-1999, and continues to lead the study.)
Each
study participant was asked to complete an in-person interview and
to provide a blood and urine sample. Also, a random sample of study
participants who had resided in their homes for at least 15 years
was asked to permit collection of house dust, tap water, and yard
soil samples (home study). About 340 cases and 340 controls are
participating in this component of the study. Laboratory analysis
of the biological samples (blood and urine) and the home environmental
samples (dust, soil, and water) are underway. Data analyses will
begin soon, and findings are expected to be reported in the year
2001.
Electromagnetic
Fields and Breast Cancer
In addition,
a subgroup of the population in Dr. Gammon's study who have lived
in their current residences for at least 15 years are participating
in a separate study to determine if electromagnetic fields (EMFs)
increase risk for breast cancer. About 600 women who have had breast
cancer (cases), and about 600 women who have not had breast cancer
(controls) are participating.
The
women were interviewed about their EMF exposure, and their homes
were visited to take EMF measurements, including spot and 24-hour
measurements; ground current measurements; and assessments of the
external power lines. No published study to date has included actual
measurements of EMF inside the homes of women who have breast cancer
and healthy women.
This
study is directed by M. Cristina Leske, M.D., M.P.H., and colleagues
at the State University of New York at Stony Brook, N.Y. The findings
are expected to be available in the year 2001.
Other
Studies
In November
2000, Steven D. Stellman, Ph.D., of the American Health Foundation,
Valhalla, N.Y., and colleagues reported findings from a case-control
study of women from Long Island that suggested that increased risk
for breast cancer does not appear to be associated with past exposure
to organochlorine compounds.
The
study included 232 women who had surgery for breast cancer (cases)
and 323 women who had surgery for non-cancerous breast disease or
for conditions unrelated to the breast (controls). The women were
treated between 1994 and 1996. They had received their care at Long
Island Jewish Medical Center, New Hyde Park, NY., and North Shore
University Hospital, Manhasset, N.Y.
Case-control
studies on the environment and breast cancer have also been conducted
in Schoharie County, under Dr. Stellman, and in Tolland County,
under Tongzhang Zheng, Ph.D., at Yale University, New Haven, Conn.
The populations in these two studies are too small to permit detailed
analyses. When results from Dr. Gammon's study are available, however,
it will be possible to look for differences in risk for breast cancer
that may be associated with body burden levels of chemicals.
Breast
Cancer Family Registry
To foster
additional research, the Metropolitan New York Registry of Breast
Cancer Families is recruiting families who have a history of breast
and/or ovarian cancer. Participants are asked to provide information,
and blood and urine samples. Having this ready resource of information
and specimens is expected to help speed research on the causes of
and susceptibility to these cancers, and on the impact of environment
and lifestyle on their development. Individuals in Metropolitan
New York may call 1-888-METRO-08 for further information. There
are numerous locations where individuals may enroll, including at
Stony Brook University Hospital and Medical Center on Long Island
by calling 1-800-867-3561.
Geographic
Information System
In 1999,
NCI awarded a 5-year contract to develop a health-related geographic
information system (GIS) for Long Island. A GIS is a computer system
of hardware and software that integrates graphics with databases.
The system is capable of storing, manipulating, displaying, and
analyzing various types of data that can be referenced by geographic
location. The prototype health-related GIS will provide researchers
a new tool to investigate relationships between breast cancer and
the environment on Long Island, and to estimate exposures to environmental
contamination.
The
LIBCSP is a complex research effort that is charting new ground
in environmental epidemiology. The assessment of environmental exposures
and determining their relationship with cancer is difficult. The
investigators are developing new environmental measurement and laboratory
techniques, and exploring new ways to study the relationship between
the environment and breast cancer.
Furthermore,
the science of developing GISs as tools to study relationships between
environmental factors and cancer is in its infancy and presents
many challenges. NCI, NIEHS, and the LIBCSP investigators are working
hard to ensure the success of the Project.
Questions
about the overall LIBCSP may be directed to:
Linda
Anderson
Director of Communications, LIBCSP, NCI
6130 Executive Blvd.
EPN, Rm. 5110, MSC 7395
Bethesda, Md. 20895-7395
telephone:
301-496-9600
fax: 301-435-6609
e-mail: andersol2@mail.nih.gov
GIS-H:
A NEW RESEARCH TOOL
The
GIS-H: A New Research Tool for Breast Cancer Studies
February 29, 2000
Introduction
The
development of a new tool, called a geographic information system
(GIS), to enhance the ability of researchers to study potential
relationships between environment contamination and breast cancer
on Long Island, is off to great start. The contract is awarded,
town meetings were held on Long Island to obtain historical information
on environmental exposures from residents, and most recently, the
members to the GIS-H Oversight Committee, which includes five community
representatives, were appointed.
GIS-H
Last
year, as part of the Long Island Breast Cancer Study Project (LIBCSP),
the National Cancer Institute (NCI) awarded a $4.87 million contract
for the development of the prototype GIS-H for breast cancer studies
on Long Island. The first two years of the contract are to develop
and deliver the system, and there are three option years for system
maintenance and data expansion to respond to research needs.
GISs
are powerful computer systems that can store, manipulate, analyze,
and display the spatial (geographic location) relationships between
dissimilar data types. The system being developed for Long Island
is called the GIS-H, with the "H" standing for "health" to emphasize
its health application.
The
GIS-H team is busily acquiring and evaluating datasets for the system.
Fifty datasets were slated for inclusion in the GIS. These datasets
come from federal state, and local government sources, as well as
private sources. They are of four types: geospatial data (for general
mapping purposes), demographic data, health outcome and health care
data, and environmental data. Summary information on the datasets
can be viewed at the GIS-H Web site.
Town Meetings
In addition, last October, the GIS-H team held seven town meetings
over four days in four locations on Long Island to hear from residents
about sources of environmental pollution and past land use that
may not be in existing records. Ellen Heineman, Ph.D., NCI Project
Officer; Roger Crystal, Project Director, AverStar, Inc.; and Iris
Obrams, M.D., Ph.D., Associate Director, Epidemiology and Genetics
Research Program, NCI, along with Linda Anderson, LIBCSP Communications
Director, and other members of the team, traveled to listen and
learn from residents about the history of Long Island and its environment.
The
residents' most frequently discussed environmental concerns focused
on contaminated water, and exposures to pesticides, industrial chemicals,
radiation, and electromagnetic fields (EMFs). One Suffolk County
resident shared a county government map of sewage treatment plants
on which she had hand drawn an overlay showing the location of waterways
closed to shellfish fishing and with high coliform counts
(bacteria associated with pollution). Another map pinpointed the
location of plumes seeping from a hazardous waste site at different
time periods.
A resident mentioned water contamination in a local swimming hole.
Another mentioned a factory that had had a large fire, and had changed
names over several decades, and therefore might not appear in databases
of industrial sites. Someone recollected that as children they considered
the soil near power right-of-ways "magic dirt" because nothing grew
in it, presumably because of heavy herbicide use. Other community
members mentioned the locations of old agricultural records, underground
storage tanks, chemical spills, and other sources of pollutants.
The
amount of work community members put into trying to track potential
environmental hazards, and the interest they showed by coming forward
to tell what they knew was impressive. The GIS-H team is reviewing
the contributions made with an eye toward using the information
to identify and perhaps fill gaps in the system. The residents'
information can be used as leads to look for other datasets, and
to compare with datasets from published sources and assess their
completeness.
The
community is welcome to continue to submit information by writing
to: LIBCSP-GIS c/o NOVA Research Company, 4600 East-West Highway,
Suite 700, Bethesda, Md. 20814-3415. In submitting contributions,
it would be helpful to know: (1) What the specific environmental
event or concern is? (2) Where the event or concern occurred? (3)
When it occurred? and 4) Who might provide more details or has written
records about it? The kinds of information that would be helpful
include: (1) how land was used for agriculture purposes, such as
the crops grown, before the mid-1970s when record keeping improved;
(2) the location(s) of closed gas stations; underground fuel storage
tanks and leaks, automobile storage, maintenance, and fuel activities;
power stations; and military bases; and (3) the location(s) of other
small industries, both past and present, whose locations may be
unrecorded.
Oversight Committee
The Oversight Committee will advise NCI and AverStar on key issues,
including overseeing the creation of the GIS-H, reviewing the data
to be included and the research proposals for use of the system,
and offering advice on strategies for protecting the confidentiality
of data. It meets for the first time on March 8 and will focus on
review of the GIS-H team's findings on the datasets, recommendations
for substitutions and additions, prioritization of datasets, and
integration of community-based information.
The
committee convenes twice yearly in person and twice via conference
call. One of the yearly in-person meetings will be held in the Washington,
D.C., area, and the other will be held on Long Island. The first
meeting is March 8 in Bethesda, Md., and plans are to meet on Long
Island in September, if the committee members are able to identify
a mutually agreeable day to meet that month. The Long Island meeting
will provide an easily accessible setting should members of the
community wish to observe the committee at work.
The
committee includes representatives from federal, state, and local
government, academia, and the community. The five community members
are: Barbara J. Balaban, A.C.S.W., Copiague; Sarah J. Meyland, M.S.,
J.D., Farmingdale; Karen J. Miller, Melville; Martha M. Rogers,
J.D., Southampton; and Victoria White, Hempstead.
