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Health officer says released data ‘may not be true’
By AMANDA HARRISON
The county’s health officer brought some startling cancer statistics Tuesday to the Calvert County commissioners, acting as the local health board, that he says “may not be true data.”
Laurence Polsky, the Calvert County Health Officer, presented Calvert’s cancer mortality rate from 2005 to 2009 compared to other counties, the state as a whole and the U.S. as detailed in the Maryland Department of Health and Mental Hygiene’s 2012 Cancer Report of the Cigarette Restitution Fund Program.
“The lung cancer rates for [Calvert] women and the breast cancer mortality rates struck me as unusual,” Polsky told the board, because higher breast cancer mortality rates are expected in areas where a larger percentage of the population is impoverished or areas where there is a high minority population, “and neither of those apply to Calvert.”
He said after he saw the data last Thursday, he called the head of cancer surveillance for the state asking if she had an explanation for the elevated numbers. He said that she had not seen the data yet, but that she agreed with Polsky that the numbers were “troubling” with lung and breast cancer.
In an email Wednesday from Polsky, he clarified that he contacted Carmela Groves, the program manager for the Maryland Center for Cancer Prevention and Control, which has a team of epidemiologists who compile and analyze cancer data from across the state.
“I don't want to imply Ms. Groves hasn't seen the data contained in the report,” he wrote in the email. “There are thousands of statistics in the report. When I asked her about the unusual findings with regard to the incidence of lung cancer in women in Calvert compared to men and the higher than expected mortality rate for those diagnosed with breast cancer, she had not noticed those particular findings.”
Polsky wrote in the email that Groves said she would work with the epidemiologists to verify the accuracy of the data, noting that “because data collection is a complex process, it may be several weeks before we receive an answer from the cancer surveillance team in Baltimore.”
“There might have been collection errors. There might have been reporting errors. There might have been calculation errors. This may not be true data,” he said during the presentation. “And if it is true, we need to know why.”
The report, which spans 2005 through 2009, reviews total cancers and seven specific cancer sites targeted by the Cancer Prevention, Education, Screening and Treatment Program: lung and bronchus, colon and rectum, female breast, prostate, oral, melanoma of the skin and cervical cancers.
According to the report, the primary purpose of the Cancer Report is to assist local health departments and local community health coalitions in planning and implementing comprehensive cancer prevention, education, screening and treatment programs.
The Maryland mortality data for single years 2008 and 2009 and five-year aggregate data for 2005 to 2009 were obtained from the Maryland Assessment Tool for Community Health, where data are obtained from the Maryland Vital Statistics Administration. CDC WONDER remained the source for mortality rates for single years 2005 through 2007, which were covered in the 2010 Cancer Report.
All rates are age-adjusted, which is “a statistical technique that allows for the comparison of rates among populations having different age distributions, by weighting the age-specific rates in each population to one standard population” — the 2000 U.S. standard population, according to the report. In addition, the report defines rate as “an estimate of the burden of a given disease on a defined population at risk over a specified period of time,” and the mortality rate is “the number of deaths for a given period [2005-2009] divided by the population at risk per 100,000 population.”
According to the report’s data, Calvert’s total cancer mortality rate is 200.
He said the areas on the state’s map with the higher cancer death rates, across all types of cancers, are areas that consist of tobacco cultivations and higher obesity rates.
“Calvert has a higher per capita cancer death rate than the state as whole,” he pointed out. “The thing that was more striking to me than that, because we know that Southern Maryland is in an area that historically because of smoking rates and obesity rates we would expect more cancers, but women’s death rates are more significantly elevated than the total.
“Traditionally, men are much more likely to develop lung cancer than women,” he said, noting the state’s 3-1 ratio. “State data actually showed that there are more women in Calvert over this five-year period that died of lung cancer than men.”
According to the data in the report, the total lung cancer mortality rate for Calvert is 57.7. Men’s mortality rate from lung cancer in the county is 59.6 and women’s is 56.4.
In neighboring Charles County, the total lung cancer mortality rate is 58.4, with men’s at 76.4 and women’s at 47.2. In St. Mary’s County, the total lung cancer mortality rate is 60.7, with men’s at 77.4 and women’s at 47.
When comparing these rates against Maryland’s lung cancer mortality rate of 51.1 and the U.S.’s lung cancer mortality rate of 50.6, all three Southern Maryland counties are 10 to 25 percent above the Maryland and U.S. rates.
“For women who got breast cancer in Calvert, they had a higher chance of dying from the cancer than most other places in the state,” Polsky explained.
He said Calvert, which has a higher female breast cancer incidence rate than the state on average, is second to Garrett County, which has the highest per capita fatality rate from beast cancer. In Calvert County, the total mortality rate for female breast cancer is 30.
Calvert’s female breast cancer mortality rate is more than 25 percent higher than the U.S.’s female breast cancer mortality rate of 23 and Maryland’s of 24.7.
In Charles and St. Mary’s counties, the total mortality rate for female breast cancer is 23.5 and 25.2, respectively. Both counties are between 10 percent below and 10 percent above the U.S. and Maryland female breast cancer mortality rates.
Commissioner Susan Shaw (R) said she noticed the dates are 2005 to 2009, “which is well before the [Dr. Sheldon] Goldberg [Center for Breast Care at Calvert Memorial Hospital], so before that there were no specialty services here.”
The Center for Breast Care opened in 2010, and was headed by the late Dr. Sheldon Goldberg.
Polsky said one of the problems is that these types of statistics “always lag by three to four years.”
He explained that the reason he brought the numbers up, despite his “reservations” about the data, was because “this is publicly available. ... I didn’t want you all to find out about it because somebody posted it on their Facebook.”
Polsky also told the board that the Calvert County Health Department’s total budget for the year is $10,253,123. About half of the budget comes from state grants, about a third comes from the county and nearly $2 million comes from collections directly through the health department, he said.
“Like most agencies, we have had some budget issues with the recession,” Polsky told the Board of Health, adding that the department lost about a third of its staff over the last five years.
Polsky said that in an effort to combat the decreased budget while maintaining services, the department has reassessed staff time in clinics, aggregated field inspections to increase efficiency and has been working with the state and county to optimize use of technology.
In another effort to increase efficiency, Polsky said the community rabies and influenza clinics will be combined in 2013. He said this measure will increase the likelihood of people protecting against both diseases and will also decrease the department’s costs.