Cancer registries and their use to identify and monitor cancer trends are an essential tool for evaluating cluster inquiries. CDC's National Center for Environmental Health conducts exposure assessments and epidemiologic studies that evaluate how people are exposed to environmental hazards and identify preventable environmental causes of cancer. The CDC's environmental health laboratory measures known and suspected cancer causing agents in human blood and urine. Three key ingredients needed for an adequate response to public concerns about cancer clusters are sufficient infrastructure, assurance of scientific credibility, and coordination between agencies. A significant advance in children's cancer surveillance is taking place with the consolidation of pediatric cancer specialists within the Children's Oncology Group with funding from the National Cancer Institute.
Scientific credibility requires that experts from many fields work together.
Independent review by expert panels also ensures the credibility of state investigations. Scientific credibility could be further enhanced by developing investigative priorities from hypotheses for why certain cancers might cluster. A work group to establish such investigative priorities is needed. Coordination between agencies is essential. The successful collaboration in Fallon, Nevada involves multiple departments within the state, the federal government, and academic institutions.