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Breast cancer is an important health issue in the United States, as the most common
cancer and the second leading cause of death among women. Since genetic and lifestyle
factors account for only approximately 25-47% of breast cancer cases, environmental
pollutants likely explain a significant portion of breast cancer incidence. The Nicholas
School of the Environment and the Comprehensive Cancer Center at Duke University are
collaborating on a project looking at environmental causes of possible breast cancer
clusters in six counties in North Carolina: Caswell, Durham, Granville, Orange, Person,
and Vance. There is a need for identification of possible pollutant sources in the
counties, along with construction of a systematic way to find relevant facilities.
This paper briefly examines the connection between the environment and breast cancer
and aims to construct an organized framework for finding possible pollutant sources
with the resources available in national and state databases. Vance County is selected
as a case study due to preliminary research indicating its unusually high rate of
breast cancer in young women (25-34 years old), and the highest discrepancy between
black and white women in fiscal year survival rates. The adaptive process of creating
the framework was performed simultaneously with the research for the case study, using
peer-reviewed literature, internet research, and meetings with state environmental
managers.
The resulting framework consists of five stages designed as an iterative flowchart.
Using Vance County as a case study, the successes and difficulties presented in the
process are evaluated. National and state databases were used to collect facility
and pollutant information that might be connected to the breast cancer cluster. The
disorganization and lack of information located online hindered the search for historic
pollutant sources in Vance. It was difficult to find facility information connected
with emitted pollutants. Recommendations on improving the process include the importance
of establishing clear goals and limitations, the lack of information found in national
and state databases, and a need for overall improved database management. Future research
may include field sampling and spatial analysis using geographic information systems
(GIS).
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