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Job Search Search:. Where: All of Canada Current Location. Search Advanced Browse. Create alert. Anthony Route 5h km Deer Lake to St. John's Route 1 4h 45min km Gander to St. John's Route 1 3h 45min km Clarenville to St. John's Route 1 2h km St. Anthony to St. John's Route 1 12h km Argentia to St. Some individuals living in the Argentia region have voiced the concern that the incidence of cancer in their communities is higher than that of the province of Newfoundland and Labrador as a whole. In the early s an environmental health assessment was conducted in response to media reports of lymphopenia among residents of the Argentia region [ 14 ].

The assessment did not find statistically significant increases in the rate of miscarriages, stillbirths, or overall mortality.

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There was a significantly higher rate of brain and bladder cancer in the region, but the authors attributed that to random variability in a small sample. One of the recommendations of the report was the ongoing evaluation of the health of the population in the Argentia region.

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Our objective is to examine the incident cancer rates in the Argentia region of Newfoundland compared to two control communities and determine whether the established presence of environmental contaminants in the past may be associated with a higher incidence of cancer in this region. We selected the communities of Stephenville and Botwood to act as comparators to Argentia in our analysis of the rates of cancer diagnosis Figure 1.

The community of Stephenville was selected as it was also the site of a US military base from to The community of Botwood was selected as a control, as there was no historical military presence in the area. Cancer data was obtained from the Newfoundland and Labrador Cancer Registry.

Data were grouped into five 5-year increments to and one 2-year increment for brain, breast, colorectal, lung, and prostate cancers. For cervical, gastric, kidney, liver, and ovarian cancers, the data were grouped into four 5-year increments — and one 6-year increment — In the latter instance, the final two time intervals were combined by the registry to suppress the relatively small numbers. For all types of cancer, the data were organized into four 5-year increments — and one 7-year increment — The crude diagnosis rate for cancer of the breast, brain, colon, lung, and prostate was calculated, as was the overall cancer diagnosis rate.

Rates were calculated in all three communities as well as the province as a whole, and all rates are presented per , person-years. Custom census data for the three communities was obtained from Statistics Canada for the years — The crude incidence rate for cancer in the Argentia region was higher than the provincial crude rate for the periods of — In the communities of Stephenville and Botwood the crude incidence rate was lower than the provincial average for all time periods except Botwood in — After completing age-standardization of the incidence rate, the incidence rate in all communities was less than the provincial average, with the exception of Argentia in the time period — ASIRs were calculated for specific types of cancer, including brain, breast, cervical, colorectal, gastric, kidney, liver, lung, ovarian, and prostate cancers, as well as for other types of cancer Figures 5 a — 5 k ; Table 2.

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As with the overall incidence rate, we observed no significant difference in incidence rates when standardized by age with the exception of gastric cancer, which was higher for four of the five time intervals Figure 5 e. The Atlantic region of Canada, including the province of NL, is known to be among those having the highest incidence rates of cancer in the country [ 15 ], as well as an aging population [ 16 ]. These factors are intertwined and likely played a role in the perception by people living in Argentia that their burden of cancer was higher.

The general trend of increased cancer incidence in all three communities and the province as a whole Figure 2 is likely due to a combination of the increasing age of the population and improved case ascertainment rates at the cancer registry, which will be discussed further as a limitation of this study.

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We can find no explanation for the comparatively low cancer rate in Botwood, our control community. The incidence rates for individual types of cancer must be interpreted with caution due to the relatively small number of cases. Among the individual types of cancer we examined, the vast majority were diagnosed in fewer than 50 people per community in each time period, and such small numbers are sensitive to chance variation and any rates calculated from such small numbers have large confidence intervals. For example, there was a sharp increase in the diagnosis of brain cancer in the Argentia region in the period — from approximately 7 to 23 cases per , person-years Figure 5 a , but the incidence rate returned to normal levels in the next time interval.

Another example is gastric cancer, for which the ASIR in the Argentia region was higher than the provincial rate in each time interval, but not at a rate that reached statistical significance Figure 5 k.

It should be noted that the southeast coast of Newfoundland and Labrador, which includes the community of Argentia, is known to have a number of families with hereditary diffuse gastric cancer [ 17 ], and we suggest that the modest increased rate of gastric cancer may be related to this syndrome. This study has some important limitations. The cancer registry in NL does not include either pediatric or hematologic cancers, and so we are unable to examine any potential trends in that data.

Additionally, the cancer registry data was not, historically, as reliable as it is today. Incidence data in the registry has improved steadily over time, particularly following electronic linkage to provincial pathology laboratories. The width of the confidence intervals around our rates and the previously mentioned fluctuations between time intervals demonstrate the relatively small communities we investigated.

Although there was some fluctuation over time, the populations in these communities ranged from 10, to 12, in Argentia, 8, to 9, in Botwood, and 13, to 15, in Stephenville. We presented all data as rates and adjusted for age distributions, but these are all relatively small communities that are vulnerable to the statistically random fluctuations in disease incidence. This was noted in Buehler et al. Economically driven outmigration from the area further complicates the assessment of the impact of environmental contamination in the Argentia area. Many individuals and families left the area to pursue economic opportunities in other parts of the province or in other provinces in Canada [ 19 ].

The rate of cancer diagnosis in this study is limited to those individuals diagnosed with cancer who were still living in the Argentia region at the time of their diagnosis; individuals who left the area and were subsequently diagnosed with cancer would not be captured in these rates. Attempting to truly quantify the cancer burden of those exposed to environmental contaminants within the Argentia region but who no longer reside there would be a time- and resource-intensive project.

Journal of Environmental and Public Health

Although we found no significant evidence of an increased risk of cancer in the Argentia region, the importance of investigating community concerns about a perceived increase in disease burden should not be underestimated. Concerns raised by people who feel they are at increased risk of developing certain disease due to environmental exposures provide an opportunity for epidemiological researchers to engage with communities, address their concerns using rigorous research methods, and provide answers based upon the available evidence.

Simpson et al. Our results are similar to the results of Buehler et al.