1. Examining cancer around Hanson Cement with regards to concerns from nearby communities
16 May 2011
Insert name of presentation on Master Slide
Presenter: Dr Ceri White,
Welsh Cancer Intelligence and Surveillance Unit

2. Agenda Background Methods Results Conclusions
Examining cancer around Hanson Cement with regards to concerns from nearby communities

3. Background Welsh Cancer Intelligence and Surveillance Unit (WCISU)
Specific concerns raised by the communities during the engagement and consultation phase
Descriptive Analysis document produced and presented
Examining cancer around Hanson Cement with regards to concerns from nearby communities

4. Background Concerns to be investigated:
Are there “pockets of cancer” in certain geographical areas?
Do the communities around Hanson Cement suffer more cancer than other comparable communities?
Is there a risk of children contracting cancer in areas downwind of the plant?
Examining cancer around Hanson Cement with regards to concerns from nearby communities

5. Background What is a cancer cluster? 95% confidence intervals p-values
What causes cancer?
Diet (35%)
Smoking and Alcohol (33%)
Occupation (4%)
Environment (2%)
Latency period of cancers
Examining cancer around Hanson Cement with regards to concerns from nearby communities

6. Cancer in the local area
Method One
Cancer in the local area
Examining cancer around Hanson Cement with regards to concerns from nearby communities

7. Method One Period of diagnosis: 1991-2008
, ,
Cancer sites mentioned previously excluding myelodysplasia and benign brain tumours
Seven MSOAs
Age specific rates – Wales and Flintshire
Observed, Expected, Standardised Incidence Ratio, 95% confidence intervals
Examining cancer around Hanson Cement with regards to concerns from nearby communities

8. Method Two Cluster Analysis
Examining cancer around Hanson Cement with regards to concerns from nearby communities

9. Method Two Period of diagnosis: 1991-2008 Maximum size of cluster:
Population: 5%, 1% of Wales
Years of diagnosis: 16 years (of 18 years)
Radius, Observed, Expected, Diagnosis period,
Relative Risk, p-value
SaTScan used as a space-time focused test
Focus: Hanson Cement
Examining cancer around Hanson Cement with regards to concerns from nearby communities

10. Method Three Radius Analysis
© Crown Copyright and database right Ordnance Survey
Produced by Welsh Cancer Intelligence and Surveillance Unit
Examining cancer around Hanson Cement with regards to concerns from nearby communities

11. Method Three Update of Journal of Public Health paper (2003)
Period of diagnosis: (twenty years)
Case and population at risk data used to 1 metre resolution
Observed, Expected, Ratio of SIR 0-2km to 2- 5km, 95% confidence interval
Examining cancer around Hanson Cement with regards to concerns from nearby communities

12. Results: Cancer in the local area
Examining cancer around Hanson Cement with regards to concerns from nearby communities

13. Results: Cancer in the local area
Examining cancer around Hanson Cement with regards to concerns from nearby communities

14. Results: Cancer in the local area
Examining cancer around Hanson Cement with regards to concerns from nearby communities

15. Results: Cancer in the local area
Examining cancer around Hanson Cement with regards to concerns from nearby communities

16. Results: Cancer in the local area
Examining cancer around Hanson Cement with regards to concerns from nearby communities

17. Results: Cancer in the local area
Examining cancer around Hanson Cement with regards to concerns from nearby communities

18. Results: Cancer in the local area
Examining cancer around Hanson Cement with regards to concerns from nearby communities

19. Results: Cancer in the local area
Examining cancer around Hanson Cement with regards to concerns from nearby communities

20. Results: Cancer in the local area
672 individual tests
650 tests similar to Wales and/or Flintshire
22 significant results – 14 high, 8 low
14 high – 10 Wales, 4 Flintshire
8 low – 3 Wales, 5 Flintshire
Examining cancer around Hanson Cement with regards to concerns from nearby communities

21. Results: Cancer in the local area
Cancer Incidence in Flintshire 020,
Examining cancer around Hanson Cement with regards to concerns from nearby communities

22. Results: Cluster Analysis
Points to note with regards cluster analysis:
Radius
Diagnosis Period
Observed and Expected numbers
p-value
Examining cancer around Hanson Cement with regards to concerns from nearby communities

23. Results: Cluster Analysis
Maximum population size = 1% (4.0km)
Examining cancer around Hanson Cement with regards to concerns from nearby communities

24. Results: Radius Analysis
Examining cancer around Hanson Cement with regards to concerns from nearby communities

25. Conclusions
The majority of analyses show that incidence of cancers in the seven MSOAs in the vicinity of the Hanson Cement plant are similar to those of Wales and Flintshire. The conclusion to the question of local cancer clusters is therefore negative.
Further analysis of Flintshire 020 for the diagnosis period showed a statistically significantly higher bowel cancer incidence in the area. After adjusting for multiple testing, this result was non significant.
Examining cancer around Hanson Cement with regards to concerns from nearby communities

26. Conclusions
Prostate, female breast and malignant melanoma produced statistically significant clusters at the 5% level with prostate and melanoma significant at the 0.1% level.
For childhood cancer, no significant clusters were identified.
We have been unable to detect an increased cancer incidence in residents living near the plant within 2km compared with 2km-5km using cancer data
Examining cancer around Hanson Cement with regards to concerns from nearby communities

27. Recommendation
WCISU would not recommend further work on perceived raised cancer incidence in proximity to the Hanson Cement plant.
Examining cancer around Hanson Cement with regards to concerns from nearby communities