When the New York State Health Department issued maps this spring of the incidence of the three most common types of cancer -- colorectal, lung, and breast -- found in each county throughout the state, and another map of the incidence of breast cancer in Nassau County, by zip code, the findings probably confirmed what many already suspected for the Great Neck area, and it brought comfort to no one. Based on state data collected from 1992 to 1996, the maps showed that the incidence of lung and colorectal cancer in Nassau County was within 20 percent below through 20 percent above, the state rate, for both men and women. No intra-county maps for these types of cancers have been issued yet by the Health Department. For breast cancer, though, maps of both the county as a whole, and one of Nassau, broken down by zip code, were provided. The incidence of breast cancer between 1993-1997 in Nassau County revealed that communities like Port Washington, Manhasset, Roslyn, and Great Neck (as well as many others throughout the county) was 15 to 49 percent above the expected incidence. These zip-codes were also classified by the NYS Health Department as "areas of elevated incidence not likely due to chance."

An April 12, 2000 Newsday article by Dan Fagin explained that state researchers developed the "expected" rate of breast cancer by first considering the breast cancer rates for the population of the entire state. "They then adjusted those rates for each zip code, depending on how old the population is and how many people live there, to come up with an estimate of the number of women who could be expected to have breast cancer," the article explained. As cancer is more prevalent in older women than younger women, they took the age of residents into account as well. Researchers then compared this estimate to the actual number of women diagnosed and reported to the state's cancer registry.

It is noteworthy that the map of breast cancer incidence in Nassau identifies not just Great Neck and nearby communities as having elevated rates; Valley Stream, Lynbrook, Oceanside, and West Hempstead fared the same, as did many others. Enigmatically, in the midst of the South Shore area mentioned just above, is Malverne, which was classified as 15 to 50 percent below the expected incidence. Sea Cliff was the zip code with the lowest incidence of breast cancer in Nassau County, with a rate more than 50 percent below what was expected. Oyster Bay had the highest in this county, with a rate 50 to 100 percent above the expected incidence of breast cancer. In the state, Rockland County had the highest rate of breast cancer.

For colorectal cancer in women, Nassau County was on a par with the majority of counties throughout the state. Hamilton and Montgomery Counties, both upstate, have cancer rates that exceeded the state's by 30 percent or more. The same was true for the incidence of colorectal cancer for males; here, Clinton and Esssex Counties joined Montgomery County in having the highest rates in New York State. Similarly, Nassau County's rate of lung and bronchus cancer in males and females was within 20 percent below to 20 percent above the state rate. The majority of the counties seemed to be in this category. The northernmost counties of New York, like St. Lawrence, Jefferson, and Essex, had the highest.

Though the mapping was not designed to identify causes of cancer, it has confirmed the observations of many and certainly pointed out the direction and need for further investigation. "We need some good statistical work," said oncologist Dr. Francis Arena, who is also president of the Sass Foundation for Medical Research. His private practice on the North Shore has seen an increase in the number of people with lung, colorectal, and breast cancer, and he has observed that his patients are younger and younger. "It is almost common now to see people in their thirties and forties; this is a big change," he said. And when it comes to breast cancer, the changes are "more pronounced." Moreover, "We are also truly seeing pockets of these cancers," Dr. Arena added, which is one reason he advocates strongly for solid statistical studies confirming local observations. He feels such results can then be used to compare this community to similar ones, as do exist in Westchester, to examine shared factors, such as environmental influences. Such measures, he hopes, will lead to the indentification of specific influences/causes. "The breast cancer rate represents something territorial," he emphasized, "and we have to focus our energies on what is different with these environments or these types of people ..."

The information in the maps also came as no surprise to Geri Barish, president of 1 in 9: The Long Island Breast Cancer Action Coalition, and a breast cancer survivor. "This has given us credibility for what we have been saying for a long time,'' she said. "We have a major problem." Like Dr. Arena, she felt we need to ask what is different here that might be a contributing factor, and she tends to think it might be the aquifer system. In addition, she hopes researchers will look into the wells. "As wells become contaminated they are closed," she stated, "but they seem to open another right next to the contaminated one." She encourages the public to press the Health Department to move ahead, rapidly. She hopes to see local health departments joining forces with water quality officials, to make changes. "We owe it to our families," she added, "even if it takes billions of dollars. We can't be afraid of the unknown. We have to do it."

Others caution against rushing off to sell one's Great Neck home and move away; the causes, they feel, are multiple. Dr. Dwight DeRisi, a breast surgeon/specialist with a Great Neck practice, commented, "Just because one area has a higher incidence doesn't mean that living there is bad for you. You have to really know the patient population, like people with family histories of breast cancer. Still, (the maps) do tell us there is a problem with Long Island, and we must investigate." Seval LaRocca, director of the Manhasset Women's Coalition Against Breast Cancer, commented that a survey they conducted two years ago which was sent to every Manhasset home, found "hereditary links." The coalition had a 20 percent return rate on their survey, and they did not focus heavily on "hot spots," or specific streets/sections of Manhasset which seem to have a cluster of those with cancer, because of a high turnover rate. "Some people are moving into and out of the area every three to four years," she said.