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Illinois State Cancer Registry

For more than two decades, residents in Crestwood, a small village in Cook County, Illinois, unknowingly drank water contaminated with possible and known carcinogens because village officials secretly used a polluted well. The story was uncovered by the Chicago Tribune in April 2009, and in anticipation of concerns about cancer incidence in Crestwood, the Illinois State Cancer Registry (ISCR) launched a cancer incidence assessment.

The ISCR's assessment examined cancer cases collected by the ISCR through mandated reporting by health facilities throughout Illinois. Using advanced geographic information system (GIS) tools and quality improvements to home addresses, the ISCR organized its data below ZIP Code levels and ascertained all cancer cases for Crestwood.

The assessment looked at the cases of residents diagnosed with cancer while living in Crestwood from 1994 to 2006. A total of 952 cancer cases were identified and compared by cancer site, race, and gender to the number and type of cancer cases expected for Cook County and Illinois as a whole during the same time.

The assessment found significantly more than expected cases of lung cancer, kidney cancer in males, and most gastrointestinal cancers (oral cavity, pharynx, esophagus, and colorectal cancers) in males. Other cancer sites were not elevated.

Due to limitations in the registry data and the presence of many other undocumented risk factors, the assessment could not establish that the cancer elevations observed in Crestwood were related to the historical presence of cancer-causing chemicals in the village's water supply. However, the assessment indicated that the water contamination may have contributed to the cancer elevations, and recommended continued monitoring and reassessments in the future.

Crestwood residents appreciated the ISCR's efforts to answer their questions. The Chicago Tribune reported the assessment results in a front-page article in March 2010.


  • Anticipate community concerns in high-profile cancer cluster situations, and act accordingly.
  • Improve address information and develop GIS tools to aid cancer cluster assessments.
  • Collaborate with CDC, the Agency for Toxic Substances and Disease Registry (ATSDR), and academic centers in data interpretation and dissemination.
  • When dealing with a situation where exposure to carcinogens has occurred, define the cancer assessment's study area by the exposure area, and be open to the possibility that the exposure may be related to cancer elevations.
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