Panel releases recommendations to guide North Carolina’s response to suspected cancer clusters

May 28, 2020

An advisory panel established by the North Carolina Policy Collaboratory at the mandate of the North Carolina General Assembly to develop strategies for assessing cancer incidence and mortality rates and patterns over time and statewide geography has released a report with its recommendations.

Recent concerns of a suspected thyroid cancer cluster in Iredell County and another for ocular melanoma near Huntersville spurred state leaders to discuss how to approach these public health concerns and to pass legislation that directed the Collaboratory, which is based at the University of North Carolina at Chapel Hill, to create the cancer research advisory panel.

The Centers for Disease Control and Prevention (CDC) defines a cancer cluster as a greater than expected number of cancer cases that occurs within a group of people in a geographic area over a defined period of time. When the number of cancer cases in a community is perceived as unusually high, community residents may become concerned about the possibility of a cancer cluster in their community.

Dr. Andrew Olshan

Andrew Olshan

The 22-member panel included epidemiologists, clinicians and environmental scientists from five universities, the Iredell County Health Department, the CDC, the National Cancer Institute and the North Carolina Department of Health and Human Services. The panel was chaired by Andrew Olshan, PhD, Barbara S. Hulka Distinguished Professor of epidemiology at the UNC Gillings School of Global Public Health and associate director of population sciences at the UNC Lineberger Comprehensive Cancer Center.

The panel held five meetings during the course of four months. Based on their discussions and the information they compiled, the panel members proposed five recommendations to improve how the state investigates a potential cancer cluster:

  1. Improve the communication process by identifying one point-of-contact person for local health departments, community members and other stakeholders;
  2. Invest in more robust infrastructure to strengthen coordination and implementation of cancer cluster investigations across the state;
  3. Enhance cancer data resources and analytical capabilities for cancer cluster surveillance;
  4. Develop a North Carolina Environmental Public Health Tracking Web-Portal; and
  5. Convene a cancer cluster advisory committee.

“Cancer clusters provide a wide array of challenges, ranging from the appropriate approach to determining if an increase in cancer cases in an area, especially one with a small number of cancer cases, is meaningful to conducting a robust investigation to determine possible causes,” Olshan said. “The panel was presented with a tall order, and I believe it has provided an excellent framework and series of diverse and impactful recommendations to help local and state officials to better address cancer cluster investigation in North Carolina.”

“I’m extremely grateful for the advisory panel’s work in developing this report,” said Senator Vickie Sawyer, who was a sponsor of the legislation that established the advisory panel. “Their tireless and thorough efforts over many months have resulted in the creation of an excellent roadmap for extending current, and initiating future strategies for determining and studying cancer clusters in North Carolina.”

“I am extremely pleased with the work of the cancer research advisory panel and particularly grateful to the leadership of Dr. Olshan at UNC Lineberger and Mr. Warren at the UNC Policy Collaboratory,” said Representative John Fraley. “The work and recommendations of the panel clearly set North Carolina apart and pointed in the right direction to address these important health matters.”

“We appreciate the General Assembly’s creation of the Collaboratory in 2016 to provide the mechanism for disseminating the research and policy expertise across the UNC System and other institutions of higher learning across the State with policymakers needing relevant science and scientific data to consider when considering complex public health concerns,” said Jeffrey Warren, PhD, executive director of the Collaboratory. “While the Collaboratory led the study, we are indebted to the numerous experts from both academia and governmental agencies that dedicated their time and knowledge to provide thoughtful and relevant input.”

Contact the UNC Gillings School of Global Public Health communications team at

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