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‘Unusual’ data is accurate


Staff writer

The “unusual” breast cancer data from a five-year study the county health officer reported to the county commissioners earlier this month has been confirmed to be accurate.

The Maryland Center for Cancer Prevention and Control confirmed the data collection and reporting in the Maryland Department of Health and Mental Hygiene’s 2012 Cancer Report of the Cigarette Restitution Fund Program was accurate for Calvert County women’s breast cancer mortality rates, according to Calvert County Health Officer Laurence Polsky.

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 breast cancer, according to the study.

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.”

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.

“We don't have enough information to know if 2005-2009 truly represents a higher rate of long-term breast cancer mortality or this was just [an] unfortunate period of time with a higher than typical number of deaths,” Polsky wrote in an email Dec. 11. “The only way we will know the truth is to wait for another 3-5 years for more data to accumulate.”

On Monday, Polsky explained that the five-year study works much better for areas with larger sample populations, like Montgomery County or Baltimore city, but that in a “relatively small sample” like Calvert, there is a higher chance of the numbers fluctuating.

“We may be in a phase when we see a higher death rate,” Polsky said of the five-year study. “Until we get to 2017, we won’t know if we truly have a higher rate of mortality.”

On Dec. 4, Polsky presented Calvert’s cancer mortality rate from 2005 to 2009 compared to other counties, the state as a whole and the U.S., to the Calvert County Board of County Commissioners, acting as the local health board.

“The lung cancer rates for [Calvert] women and the breast cancer mortality rates struck me as unusual,” Polsky told the board Dec. 4, 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 told the commissioners he was weary of the data, citing several possibilities, including incorrect data collection, reporting and calculation errors.

Polsky said Monday the DHMH epidemiologists are still working with the lung cancer mortality rates for women and he hopes to have information about the accuracy of that data in January.

Now that the data has been proven accurate for breast cancer mortality rates, Polsky said in an email Dec. 11, the Calvert County Health Department “is going to approach this as a true medical problem and not a potential statistical anomaly.”

He said Monday the epidemiologists at DHMH are currently working on breaking down the breast cancer mortality rate by age and ZIP code, which he hopes to have by the end of the year.

“If it turns out there are pockets of abnormal populations [in Calvert] ... we will be able to target our efforts to those areas,” Polsky said.

He has already been in contact with the Calvert Commission for Women and the Calvert Memorial Hospital community outreach department, so that when the information comes in, “we have a team that’s already assembling” to take action.

He noted that the Dr. Sheldon Goldberg Center for Breast Care at CMH — which was opened in 2010 and headed by the late Dr. Sheldon Goldberg — may already be addressing some of the concerns, “but it’ll be a few years down the road before we know.”