ALBANY, N.Y. -- The New York Health Department recently published breast cancer rates by ZIP code for the entire state, the first time such widespread mapping of a cancer has been produced in such detail.
Not surprisingly, the data show that the highest rates of breast cancer occurred on Long Island, where the disease has become a potent political and public health issue and local survivors' groups have, on their own, pioneered the creation of cancer maps. The department will produce ZIP code maps for other common cancers over the next several months.
While praising the state, many advocates of the mapping project said that it was too long in the making and complained that the state still had not achieved one of the project's original goals: to compare spots where cancer rates are elevated to the locations of known sources of pollution. Officials in the Health Department and elsewhere in the Pataki administration have said they intend to produce maps matching cancers to pollutants but would not say when.
Through analysis of the figures -- which include cancer cases diagnosed from 1993 through 1997 by the ZIP code of each patient's residence -- the Health Department identified several regions around the state as "areas of elevated incidence not likely due to chance." Most of Suffolk, Nassau and Rockland Counties fell into this classification. Not counting ZIP codes with such small numbers of cases that statistical anomalies could easily occur, the four ZIP codes with the highest rates of breast cancer statewide were in Suffolk County.
Other areas designated with "elevated incidence not likely due to chance" included swaths of central and southern Westchester County, the Upper East Side of Manhattan, southern Brooklyn, eastern Staten Island, Rochester and its suburbs, and Buffalo and its suburbs. Over all, New York City had a below-average rate of breast cancer.
The areas with high breast cancer rates correlate strongly to known risk factors like affluence, having children relatively late in life and Jewish heritage. But in many cases, they also match known sources of industrial air emissions, toxic waste sites and contaminated ground water wells.
The full data are available on the department's Web site, at www.health.state.ny.us/nysdoh/-cancer/csii/nyscsii.htm.
"I must tell you that the maps do have limitations," said Dr. Antonia C. Novello, the state health commissioner, at a news conference where she released the maps. "They can suggest the areas for more research, but they cannot by themselves tell us the causes of the cancers."
She said the project, under way since 1998, had moved slowly in part because the state's cancer registry, which keeps detailed reports on every cancer case, had some sloppy record-keeping and had to be cleaned up. "I want to do it as fast as you guys do, but I want to do it well," she said. "Give a little bit of trust to the department."
But Assemblyman Richard L. Brodsky, a Democrat who has been the primary advocate of cancer mapping in the Legislature, said that the data should be much more refined and he accused the department of dragging its feet.
'These maps are useless'
"These maps are useless," said Brodsky, who is chairman of the Environmental Conservation Committee. "They don't really identify cancer clusters, which occur at the neighborhood level, well below the ZIP code level. And they haven't told us anything about environmental factors."
Assemblywoman Maureen C. O'Connell, a Nassau County Republican and a former oncology nurse, said, "The delay in getting this map done was of concern to all of us."
David Momrow, senior vice president of the American Cancer Society's New York chapter, reacted cautiously to the maps but called them "a significant achievement."
As originally conceived by the Legislature two years ago, the maps would have compared high cancer rates to known sources of pollution and would have been produced in a few months. Places where the two factors matched, advocates said, could be places for epidemiologists to look for environmental causes for cancer.
Gov. George E. Pataki, a Republican, vetoed financing for that project. Later, under fire from cancer survivors' groups, he said the Health Department would take on the project, using available money, and the department promised the first maps by the end of the year.
The first maps came, instead, more than a year later, and they showed rates of various kinds of cancer at a county level -- data the department had already been publishing for several years.