Long Island Breast Cancer Study Project
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.
Much of the research is now completed. The major findings from the centerpiece
population-based case-control study titled Breast Cancer and the Environment
on Long Island were reported in 2002, and are described briefly below.
Further analyses and a follow-up study are in progress. A case-control
study, based on many of the study subjects from the centerpiece study,
investigated electromagnetic fields (EMF) and increased risk for breast
cancer. The major findings from this study were reported in 2003 and are
summarized here.
The Project also includes development of the Geographic
Information System for Breast Cancer Studies on Long Island (LI GIS),
which is a unique tool for use in studying relationships between environmental
exposures and breast cancer.
Altogether, $30 million has been spent for the research and the LI GIS.
Breast Cancer and the Environment
The cornerstone of the LIBCSP is a population-based, case-control study
titled Breast Cancer and the Environment on Long Island. The study focused
on investigating whether organochlorine pesticides, including DDT, polychlorinated
biphenyls (PCBs), dieldrin, and chlordane; and polycyclic aromatic hydrocarbons
(PAH), a ubiquitous pollutant caused by incomplete combustion of various
chemicals including diesel fuel and cigarette smoke, are associated with
risk for breast cancer among women on Long Island.
The study was led by Marilie Gammon, Ph.D., of the University of North
Carolina at Chapel Hill, N.C. All women in Nassau and Suffolk counties
who were newly diagnosed with breast cancer during a one-year period beginning
in August 1996 (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. Altogether, 1,508 women who were newly
diagnosed with in situ or invasive breast cancer, and a similar number
of women who did not have cancer participated in the study. (In situ breast
cancer is early cancer that has not spread to neighboring tissue.)
Dr. Gammon and colleagues found that organochlorine compounds are not
associated with the elevated rates of breast cancer on Long Island. However,
the researchers said that it is possible that breast cancer risk in some
individuals may be associated with organochlorine exposures because of
individual differences in metabolism and ability to repair DNA damage,
and they are continuing to investigate these possibilities. The researchers
also found that exposure to PAHs was associated with a modest increased
risk for breast cancer. These findings were reported in two
papers that were published in August 2002.
A third paper describes
the full study population and research methods, and the established risk
factors for breast cancer found in the group. Many of the well-known breast
cancer risk factors were confirmed in the study. These risk factors included
increasing age, having a family history of breast cancer, having a first
child at a later age (age 28 or older in this study), never having given
birth to a child, and having higher income. Read additional
details on the study and its findings.
In August 2001, Dr. Gammon received a 4-year grant to conduct a follow-up
study. The new study seeks to determine whether the environmental
factors investigated in the initial study and other lifestyle factors
influence disease-free survival and overall survival among a population-based
sample of Long Island women diagnosed with breast cancer.
Electromagnetic Fields and Breast Cancer
 A
subgroup of the population that participated in Dr. Gammon's study and
who had lived in their current residences in Nassau and Suffolk counties
for at least 15 years participated in a separate study to determine if
EMFs increase risk for breast cancer. There were 576 women who had been
diagnosed with breast cancer (cases) and 585 women who had not had the
cancer (controls) who participated in this
study.
M. Cristina Leske, M.D., M.P.H., and colleagues at Stony Brook University,
conducted a comprehensive home assessment of the study participants' exposure
to EMFs through personal interview and by taking a variety of EMF measurements
within and around the outside of the home. They did not find an association
between residential exposure to EMFs and risk for breast cancer. In additional
analysis, they also found no association between use of electric blankets
and risk for breast cancer. These findings
were reported in 2003. Some further analysis of the data is under
way and is expected to be reported in 2004.
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
numbers of women diagnosed with breast cancer in these two locations were
too small to permit valid analyses.
See the Research Projects section for a complete
list of studies.
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. The Registry
was funded initially as part of the LIBCSP. It has continued to be funded
separate from the LIBCSP as one of six international breast cancer registries
funded by NCI.
Geographic Information System
In 2001, NCI completed development of the Geographic Information System
for Breast Cancer Studies on Long Island (LI GIS, and formerly called
GIS-H). This advanced research tool provides scientists a new mechanism
to investigate relationships between breast cancer and the environment
on Long Island. It also enables researchers to estimate exposure to environmental
contamination.
GISs are powerful computer systems that permit layers of information,
such as on cancer and the environment, to be superimposed and manipulated.
The systems consist of hardware, software, and data tables.
The LI GIS consists of more than 80 datasets that have geographic, demographic,
health, and environmental data on Nassau and Suffolk counties and, to
a lesser extent, on surrounding counties. It also has statistical and
analytical tools for researchers. Researchers are welcome to apply to
use the system, and additional information about the LI GIS is available
at http://li-gis.cancer.gov.
The system also will provide the public an internet mapping facility
which currently is in development. Visitors will be able to see and use
some of the content and features of the GIS-H without needing special
computer skills. They may choose from a list of interactive maps available
on the Web site or choose to install the ArcExplorer mapping software
on their computers. This software will allow visitors to access LI GIS
map services to construct their own maps.
The LI GIS was developed and is maintained by Titan (formerly AverStar,
Inc.), Vienna, Va., under a contract with NCI.
The LIBCSP is a complex research effort that has charted new ground in
environmental epidemiology. The assessment of environmental exposures
and determining their relationship with cancer is difficult. The investigators
have been 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 have worked
hard to ensure the success of the Project.
Questions about the overall LIBCSP may be directed to:
Shannon Lynch, M.P.H.
Program Analyst
Epidemiology and Genetics Research Program
Division of Cancer Control and Population Sciences
National Cancer Institute
6130 Executive Blvd.
EPN, Rm. 5141, MSC 7393
Bethesda, Md. 20895-7393
telephone: 301-496-9600
fax: 301-435-5477
e-mail: lynchs@mail.nih.gov
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