2007.12.11 – PV report requires further review

PV report requires further review

BY SHAWN A. HESSINGER
STAFF WRITER
shessinger@republicanherald.com
12/11/2007

Reaction from a federal agency has experts researching a local blood cancer looking for backup.

Dr. Paul Roda, an oncologist at Geisinger Hazleton Cancer Center/Geisinger Northeast Pennsylvania, said a presentation on local numbers of polycythemia vera, a cancer characterized by an elevated red blood cell count, was made Monday at a national convention in in Atlanta, Ga.

However, Roda, who attended the annual meeting of the American Society of Hematology, said the next step would likely be for Dr. Ronald Hoffman of the Mount Sinai School of Medicine in New York to recruit another specialist to review the findings.

“The sense of the presentation was that there is an elevated level but that he needs to bring in an epidemiologist to make a determination,” said Roda, who co-authored the report.

On Oct. 24, Hoffman, a national expert on polycythemia vera, made a presentation in Hazleton confirming 38 cases of the disease in eastern Schuylkill and northern Luzerne counties where statistically only 25 might have been expected – 52 percent higher than anticipated – over the last five years.

An abstract for the report posted on the Internet prior to the meeting seemed to reverse an earlier insistence by the Agency of Toxic Substances and Disease Registry that the study had found no links between the incidence of the disease and environmental exposure.

The abstract for the meeting revealed that 18 of the 38 cases confirmed by blood tests for a tell-tale genetic indication lived within 13 miles of a former Kline Township Superfund site.

McAdoo Associates was licensed as a metal reclamation and incineration facility on an 8-acre former mining site but was placed on the Environmental Protection Agency’s Superfund National Priorities List of most contaminated sites after community and environmental leaders say a variety of volatile organic chemicals and other wastes were dumped there.

After a federally mandated cleanup of the site, including removal of contaminated soil and 7,000 drums of chemicals in the early 1980s, the property was removed from Superfund status in 2001.

However, in another about face Friday, Agency of Toxic Substances and Disease Registry officials insisted the abstract had incorrectly characterized residents living within a 13-mile radius of McAdoo Associates between 1975 and 1990 during the site’s operation and cleanup as having had a 4½ times greater chance of developing the disease.

On Friday, federal officials insisted researchers may have injected bias into the study by failing to consider that many diagnosed with the disease also lived in different places away from the former Superfund site over that period.

“I can’t argue with that. All I can tell you is the longer you are in the area the more chance you have of developing the disease,” Roda added.

On Friday, Hoffman told the Associated Press he still considered evidence to point to an environmental factor for the elevated disease rate.

“Based upon the data, there’s significant concern that there is something in the environment leading to the development of polycythemia vera in the area. The nature of what’s causing it is unknown at the moment and is going to require further study,” he said.

After federal and state health officials raised concerns over the statistical evaluation of the 18 cases found within proximity to the Superfund site, Roda said, researchers will now seek input from an independent epidemiologist to prove suspicions that a cancer cluster, a statistically significant amount of the disease, is present.

“We still believe there’s a cluster. We believe in our science,” Roda said.

He added that the study had also revealed the importance of genetic testing to distinguish the disease from a secondary condition generally associated with cigarette smoking and Black Lung disease.

Officials at the Agency of Toxic Substances and Disease Registry could not be reached for comment on the report Monday.