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Cancer and chronic disease clusters 

Cancer and chronic disease clusters
Chapter:
Cancer and chronic disease clusters
Author(s):

Alex G. Stewart

, Sam Ghebrehewet

, and Richard Jarvis

DOI:
10.1093/med/9780198745471.003.0017
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date: 18 October 2017

Clusters of disease are often reported to health protection and a finger pointed at a nearby environmental hazard that is thought to be the cause. There is an expectation that the causal linkage will be clarified and action taken to alleviate the resulting anxiety and stop further ill health. Not all reported clusters are real, but all are worth some level of investigation to alleviate anxiety. However, investigating such clusters is not easy. Neither is investigating causal linkages to environmental issues. Using an example of childhood cancer and contaminated land, this chapter takes a stepwise, structured approach to the investigation, defining realistic outcomes and clear criteria to stop such an investigation. The vital role of a multi-agency incident team to integrate health studies and environmental investigations is explored. Readers will be able to undertake such investigations for themselves across a wide range of putative clusters of chronic diseases.

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