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Local Oncologist: Quirk of Stats, Cigs Behind Higher Fridley Cancer Rates

MN Oncology's Tom Amatruda looks to smoking, statistical happenstance.

Dr. Tom Amatruda, a genetic specialist at Minnesota Oncology's Fridley clinic, said he does not believe environmental factors have significantly elevated Fridley residents’ risk for contracting cancer.

Last month, an epidemiologist at the Minnesota Cancer Surveillance System released data between 2000 and 2009 and the city’s lung cancer rates 30 percent higher.

But Amatruda said in an interview Thursday that these numbers could be written off to statistical variation and elevated smoking rates.

“A 10 percent higher rate of cancer in one community isn’t that significant,” he said. “You have now a town of about 40,000 with a 10 percent higher rate of cancer, and, well, there’re probably three towns around here of about 40,000 with about a three percent lower rate of cancer and unfortunately that’s just the way statistics go.” (For the record, the puts Fridley's population at 27,208.)

Amatruda said the 30 percent increase in lung cancer rates (48 percent among women) did indicate a “real phenomenon” but that it was likely caused by the popularity of smoking in Fridley 20 years ago.

He said he found data from the Minnesota Adult Tobacco Survey that show a slightly higher than average rate of smoking in Fridley in the 2000s and that he suspects there would be a similar trend in the 1970s and 80s.

“Lung cancer is caused by tobacco,” he said. “Anoka County has [historically] had access to tobacco in bars, whereas Ramsey and Hennepin county [had earlier] closed that down so it’s kind of more smoker friendly and therefore more cancer friendly.”

Amatruda said he was surprised to hear that there were and that there might be “some factors from them” but that smoking dwarfed contamination as a risk factor for cancer.

“I would think about it more if there was a strong cluster of a very rare cancer,” he said. “A cluster is going to have to be at least two or three times higher to see it stick up above the statistical variation.”

Amatruda said another possible explanation for higher than expected cancer rates could be lower than expected insurance rates.

“About 9 percent of people don’t have insurance in the Twin Cities metro area, maybe a little more here because this is not a rich area,” he said. “People don’t have insurance, they don’t get preventive care. When they don’t get preventive care, they get diagnosed with cancers at a more advanced stage. When they get diagnosed with cancers at a more advanced stage, the likelihood of death from cancer is higher.”

Maureen Steltz April 12, 2012 at 11:41 PM
I would like to see Dr. Amatruda's statistical evidence demonstrating that Fridley had a higher rate of smoking when compared to Minnesota as a whole to validate his argument of statistical variation and smoking in bars as the primary cause of the elevated cancer rates in Fridley. I would also like Dr. Amatruda to address the incidence of cancer in Fridley residents who NEVER smoked. And what about the many other kinds of cancer that are being reported. Did smoking in bars cause them as well? Let's get serious. A ten percent variation is statistically significant. A 48% elevation in the rate of lung cancer in Fridley women is a statistic that screams for further research. For Dr. Amatruda to give his professional opinion when he clearly lacks a full understanding ("was surprise to hear") of the environmental contamination in Fridley from five Superfund sites along with TCAAP in New Brighton/Arden Hills is irresponsible. I hope he will take the time to become better informed on this issue before making additional comments. Certainly smoking is a known cause of cancer. Unfortunately so is exposure to TCE.
T K April 13, 2012 at 04:20 AM
Yeah Sure, you know so much, Say what would you say if 10 out of 35 of your friends and neighbors you grew up with told you someone in their Families have been affected with some of the forms of Cancer and other Ailments said to be from the T.C.E, contamination which you can see was present and went on for years without the city saying ONE word to its residents ?, Huh, I can NOT hear you ??? That's what I thought...... Quit plying a role for the City and begin to realize we got sick from its water that we trusted.
A. Meisner April 13, 2012 at 04:42 AM
Just a methodology point from my husband: we can not say that the 10% variation is statistically significant or not -- it completely depends on the variability in the state and local data. We would have to ask the epidemiologist, John Soler, if it's statistically significant. The 48% higher lung cancer rate may also not be statistically significant if it can be correlated to known causes or known risk factors (e.g. smoking) that were higher in the Fridley population. So your question about the data on smoking rates is important to know in order to evaluate Fridley's cancer rate disparity.
Pat Pierce April 13, 2012 at 12:29 PM
He talks about “About 9 percent of people don’t have insurance in the Twin Cities metro area, maybe a little more here because this is not a rich area,” he said. “People don’t have insurance, they don’t get preventive care. When they don’t get preventive care, they get diagnosed with cancers at a more advanced stage. When they get diagnosed with cancers at a more advanced stage, the likelihood of death from cancer is higher.” We aren't talking about cancer DEATHS, we are talking about the rate of cancer in Fridley. Perhaps he should have been told about Fridley Superfund sites and TCE. Then he could have done some research and this interview would have been worthwhile.
Mark Olson April 13, 2012 at 01:40 PM
M.O. I would like to know when these oncologist's are going to get on the same page.I am seeing an oncologist at Fridley Med Ctr who also work for Mn oncology who told me repeatedly that my lung cancer was not caused by my smoking. He told me smoking weakens the body so you can get cancer more easlily, but it wasn't the cause of it. My oncologist is not the only medical person who has told me this, cancer nurses, radiologist and M.D.'s. Don't get me wrong I am not justifying smoking. But I find it odd that what I've been reading on this site about the polluted sites in Fridley. I live 2 blocks from Kurt Manufacuring and 3 blocks from the site on Rice Creek and Old central. Let alone the water issue. I think docters like this Amatruda need to rethink how quick they are to lay the blame on cigarettes and ignore the pollution issuses.
Larry Lavascoius April 13, 2012 at 03:55 PM
I have lived in Fridley for 27 years and do not have cancer. So that means that there must not be an issue. That makes as much sense as saying that living in Fridley causes cancer. Before we all jump to conclusions about pollution, why not take a closer look? Are these cases concentrated around the Superfund sites? That would be a good place to start in my estimation.
Jana Piscioneri April 13, 2012 at 04:54 PM
I would like to understand how he proposes to explain away the fact that I, who worked at FMC/NIROP are under testing for potential lung cancer and have never smoked a day in my life, and my son with whom I was pregnant when I worked at FMC has been diagnosed with brain cancer and he has never smoked a day in his life and a working colleague of mine at FMC was diagnosed with leukemia and she never smoked either. Nice try, Doctor, but pardon the pun - no cigar.
Wendy Olson April 14, 2012 at 08:25 PM
I would like to note that nothing in the above article indicates that Dr. Amatruda said statistical variation and smoking in bars is the “primary cause of the elevated cancer rates in Fridley.” The article states, “But Amatruda said in an interview Thursday that these numbers COULD BE written off to statistical variation and elevated smoking rates.” I believe the epidemiologist who ran the numbers indicated that the 10% variation is probably due to an excess rate of LUNG cancer noted in the stats. I agree that while smoking is not the only cause of lung cancer, it has been shown to be the major cause. It’s also probably true that the demographics of this city could indeed show a higher number of smokers. But this information was presented to possibly explain the higher rate of LUNG cancers, which is where the excess showed up in the data. I don’t believe he tried to relate smoking to all cancers in Fridley as some of these comments would indicate. I think it still needs to be determined whether this is in fact a significant enough variation to be considered a cancer cluster before we start to speculate on a possible cause or start laying blame.
Doris Knutson April 14, 2012 at 09:51 PM
The expert oncologist should have investigated more thoroughly regarding the various cancers that have occurred in Fridley. We have lived in Fridley over 40 years and, within a space of only SIX homes on our side of the street, there have/has been: two cases of leukemia, two lung cancers, one prostrate, and one breast cancer. I do not believe all of these happened due to smoking or hanging out in some smoky bar, Dr. Amatruda. Do you? TCE?? How about it, City Council?
Mike Hoag April 14, 2012 at 11:32 PM
Oncology is one of the most expensive and most profitable fields of medicine. Stephan Seeßle, MD
Wendy Olson April 14, 2012 at 11:43 PM
Really? This is so irrelevant.

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