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BackgroundThe World Trade Center (WTC) attacks on 11 September 2001 created a hazardous environment with known and suspected carcinogens. Previous studies have identified an increased risk of prostate cancer in responder cohorts compared with the general male population.ObjectivesTo estimate the length of time to prostate cancer among WTC rescue/recovery workers by determining specific time periods during which the risk was significantly elevated.MethodsPerson-time accruals began 6 months after enrolment into a WTC cohort and ended at death or 12/31/2015. Cancer data were obtained through linkages with 13 state cancer registries. New York State was the comparison population. We used Poisson regression to estimate hazard ratios and 95% CIs; change points in rate ratios were estimated using profile likelihood.ResultsThe analytic cohort included 54 394 male rescue/recovery workers. We observed 1120 incident prostate cancer cases. During 2002–2006, no association with WTC exposure was detected. Beginning in 2007, a 24% increased risk (HR: 1.24, 95% CI 1.16 to 1.32) was observed among WTC rescue/recovery workers when compared with New York State. Comparing those who arrived earliest at the disaster site on the morning of 11 September 2001 or any time on 12 September 2001 to those who first arrived later, we observed a positive, monotonic, dose-response association in the early (2002–2006) and late (2007–2015) periods.ConclusionsRisk of prostate cancer was significantly elevated beginning in 2007 in the WTC combined rescue/recovery cohort. While unique exposures at the disaster site might have contributed to the observed effect, screening practices including routine prostate specific antigen screening cannot be discounted.

BACKGROUND: Individuals with a history of cancer may be more susceptible to severe COVID-19 due to immunosuppression, comorbidities, or ongoing treatment. We linked inpatient claims data on COVID-19 hospitalizations to cancer diagnoses from the New York State Cancer Registry (NYSCR) to examine associations between prior cancer diagnoses and hospitalizations for COVID-19, and factors associated with death at discharge after COVID-19 hospitalization. METHODS: New York State (NYS) residents diagnosed with invasive cancer before July 1, 2021, who were alive on January 1, 2020, were identified from NYSCR data. We obtained claims data for discharge year 2020 and the first half of 2021 from NYS's Statewide Planning and Research Cooperative System (SPARCS), and we linked inpatient records with COVID-19 as the primary diagnosis to cancer data from the NYSCR using deterministic matching methods. We calculated descriptive statistics and conducted multivariable-adjusted logistic regression analyses to examine associations of cancer case characteristics with COVID-19 hospitalization and with vital status at discharge among patients with a history of cancer. All analyses were conducted in SAS 9.4. RESULTS: Our analysis included 1,257,377 individuals with a history of cancer, 10,210 of whom had a subsequent primary COVID-19 hospitalization. Individuals with a history of cancer were 16% more likely to be hospitalized with COVID-19, compared to the general population of NYS, after adjusting for age and sex (95% CI, 14%-19%). Factors independently associated with COVID-19 hospitalization among cancer patients included older age, male sex, non-Hispanic Black race or Hispanic ethnicity, diagnosis with late-stage cancer or with multiple tumors, more recent cancer diagnosis, and New York City (NYC) residency at the time of cancer diagnosis. Factors independently associated with death at discharge among individuals with COVID-19 hospitalization and a prior cancer diagnosis included older age, male sex, non-Hispanic Black or non-Hispanic Asian/Pacific Islander race or Hispanic ethnicity, residence in NYC at the time of COVID-19 hospitalization, and an active cancer diagnosis claim code at the time of COVID-19 hospitalization. CONCLUSION: This claims-based study identified higher risks of COVID-19 hospitalization and death at discharge among individuals with a history of cancer, and particularly those in certain demographic and diagnostic groups.

Background: Cancer incidence in exposed rescue/recovery workers (RRWs) and civilians (non-RRWs) was previously reported through 2008. Methods: We studied occurrence of first primary cancer among World Trade Center Health Registry enrollees through 2011 using adjusted standardized incidence ratios (SIRs), and the WTC-exposure-cancer association, using Cox proportional hazards models. Results: All-cancer SIR was 1.11 (95% confidence interval (CI) 1.03–1.20) in RRWs, and 1.08 (95% CI 1.02–1.15) in non-RRWs. Prostate cancer and skin melanoma were significantly elevated in both populations. Thyroid cancer was significantly elevated only in RRWs while breast cancer and non-Hodgkin's lymphoma were significantly elevated only in non-RRWs. There was a significant exposure dose-response for bladder cancer among RRWs, and for skin melanoma among non-RRWs. Conclusions: We observed excesses of total and specific cancers in both populations, although the strength of the evidence for causal relationships to WTC exposures is somewhat limited. Continued monitoring of this population is indicated.

Race is an important demographic variable in cancer statistics. The determination of an accurate race is difficult when a patient has conflicting race data from different reporting sources. In the New York State Cancer Registry, 11.6% of cases diagnosed between 1995-2008 had conflicting race information from different sources. Here we report on a new algorithm to aid in resolving these conflicts.

Race is an important demographic variable in cancer statistics. The determination of an accurate race is difficult when a patient has conflicting race data from different reporting sources. In the New York State Cancer Registry, 11.6% of cases diagnosed between 1995-2008 had conflicting race information from different sources. Here we report on a new algorithm to aid in resolving these conflicts.

Although each tumor should have one valid date of diagnosis, multiple dates are often received fromdifferent reporting sources. Resolving these inconsistencies can be a labor-intensive task. To ourknowledge, no algorithms for the consolidation of diagnosis dates have been published. The New YorkState Cancer Registry (NYSCR) has developed such an algorithm and would like to share it with otherregistries. A thorough evaluation of the algorithm suggests that it improves database accuracy while saving time and labor.also improves dat.

In the 2000 Census, New York State had about 82,000 single-race American Indians, with about 47,000 indicating a specific tribal affiliation. The largest affiliations were Iroquois (18,000, encompassing Mohawk, Seneca, Onondaga and several other groups, about half of whom were living on or near one of six upstate reservation areas), Latin American Indians (11,000, primarily in New York City), and Cherokee (3,000, also primarily in New York City). Throughout the state, the number of American Indian cancer cases is well below what would be expected given the population sizes. The purpose of our project was to identify additional America Indian cancer cases that were miscoded in the New York State Cancer Registry. We pursued several strategies that increased rates by as much as 50%: linkage to the Indian Health Service, geographic-based assignment, and surname-based assignment. New York State now has a much more accurate picture of the cancer burden among its American Indian population living outside of New York City.

Context: The terrorist attacks of September 11, 2001, resulted in the release of known and suspected carcinogens into the environment. There is public concern that exposures may have resulted in increased cancers. Objective: To evaluate cancer incidence among persons enrolled in the World Trade Center Health Registry. Design, Setting, and Participants: Observational study of 55 778 New York State residents enrolled in the World Trade Center Health Registry in 2003-2004, including rescue/recovery workers (n = 21 850) and those not involved in rescue/recovery (n = 33 928), who were followed up from enrollment through December 31, 2008. Within-cohort comparisons using Cox proportional hazards models assessed the relationship between intensity of World Trade Center exposure and selected cancers. Main Outcome Measures: Cases were identified through linkage with 11 state cancer registries. Standardized incidence ratios (SIRs) adjusted for age, race/ethnicity, and sex were computed with 2003-2008 New York State rates as the reference, focusing on cancers diagnosed in 2007-2008 as being most likely to be related to exposure during September 11 and its aftermath. The total and site-specific incidence rate differences (RDs) per 100 000 person-years between the study population and the New York State population in 2007-2008 also were calculated. Results: There were 1187 incident cancers diagnosed, with an accumulated 253 269 person-years (439 cancers among rescue/recovery workers and 748 among those not involved in rescue/recovery). The SIR for all cancer sites combined in 2007-2008 was not significantly elevated (SIR, 1.14 [95% CI, 0.99 to 1.30]; RD, 67 [95% CI, −6 to 126] per 100 000 person-years among rescue/recovery workers vs SIR, 0.92 [95% CI, 0.83 to 1.03]; RD, −45 [95% CI, −106 to 15] per 100 000 person-years among those not involved in rescue/recovery). Among rescue/recovery workers, the SIRs had significantly increased by 2007-2008 for 3 cancer sites and were 1.43 (95% CI, 1.11 to 1.82) for prostate cancer (n = 67; RD, 61 [95% CI, 20 to 91] per 100 000 person-years), 2.02 (95% CI, 1.07 to 3.45) for thyroid cancer (n = 13; RD, 16 [95% CI, 2 to 23] per 100 000 person-years), and 2.85 (95% CI, 1.15 to 5.88) for multiple myeloma (n = 7; RD, 11 [95% CI, 2 to 14] per 100 000 person-years). No increased incidence was observed in 2007-2008 among those not involved in rescue/recovery. Using within-cohort comparisons, the intensity of World Trade Center exposure was not significantly associated with cancer of the lung, prostate, thyroid, non-Hodgkin lymphoma, or hematological cancer in either group. Conclusions: Among persons enrolled in the World Trade Center Health Registry, there was an excess risk for prostate cancer, thyroid cancer, and myeloma in 2007-2008 compared with that for New York State residents; however, these findings were based on a small number of events and multiple comparisons. No significant associations were observed with intensity of World Trade Center exposures. Longer follow-up for typically long-latency cancers and attention to specific cancer sites are needed.