A study that identifies the bottom third of Florida as a massive brain cancer cluster has set off a firestorm among Acreage residents worried about their community's reputation.
They insist that the report, which surfaced on the Internet last month, is proof that cancer isn't a problem solely for their central Palm Beach County community, where health officials last month declared a cluster of cases among children and teenagers.
They have besieged state legislators, health officials and anyone else who could change the local designation or spread word of the report.
But in interviews, the study's authors say their findings don't discredit the state's cluster designation in The Acreage.
What's more, The Acreage's cluster is part of what's pushing up rates throughout South Florida in the new study, said Richard Clapp, an epidemiologist and professor of environmental health at Boston University.
The state Department of Health declined to discuss the study, due to be published next month in the scholarly journal Pediatric Blood & Cancer. The authors include researchers from the University of West Florida in Pensacola and the Nemours Center for Childhood Cancer Research in Delaware.
The study has swiftly grabbed attention in The Acreage.
"Our community has been labeled as the poster child for 'Pediatric Cancer Clusters' in the State of Florida," Acreage residents Carl and Debra Garcia wrote to state Rep. Joseph Abruzzo last week in an e-mail seeking answers about the new report. "We want the truth both for those directly stricken by health issues and the community at large."
The study, which compares childhood cancer rates throughout Florida ZIP codes from 2000 through 2007, wasn't meant to challenge or conflict with state findings, its authors said.
The report doesn't address causes of the elevated cancer rates but says the findings "are suggestive of environmental factors or common risk factors in the areas."
The study found that in 2006 and 2007, South Florida had more than twice as many childhood brain tumors and cancers as would be expected in that size population: 52 cases instead of 24.
"This may be an area of concern for the health authorities to look deeper into — that's pretty much where the results in the article end," said study author Raid Amin, a statistics professor at the University of West Florida.
Based on maps accompanying the study, the region with elevated cancer rates appears to include the Glades and other parts of western Palm Beach County, as well as barrier islands along the Atlantic, but not the bulk of the county's cities and suburbs. It also includes parts of Broward and Miami-Dade counties, the Gulf Coast and sites north of Lake Okeechobee.
Researchers declined to provide more detailed geographic data.
The study has acknowledged shortcomings, chief among them its population counts.
The authors used 2000 U.S. census data to estimate the region's overall population, which they then compared with numbers of cancer cases taken from a state registry.
"You have to wonder as you get further away from 2000 whether that rate is influencing the results," said Kimberly J. Johnson, a postdoctoral research fellow with the University of Minnesota's Division of Epidemiology and Clinical Research. Johnson peer-reviewed the study, titled "Epidemiologic Mapping of Florida Childhood Cancer Clusters," for its publication in the journal.
To ensure that nearly decade-old population figures hadn't skewed the results, the researchers examined census estimates and state demographic data for later years. Those estimates made them reasonably confident that southern Florida's population did not rise significantly faster than other parts of the state, Amin said.
Still, "you could have small-area migration that could really influence the rates," Johnson said. "They did the best they could."
Population, as well as age breakdowns within the population, could skew the results, agreed Babette Brumback, an associate professor of biostatistics at the University of Florida.
"The validity of the results would depend on the validity of those projections," Brumback said.
Palm Beach Post staff writer Stacey Singer contributed to this report.