CDC/ATSDR Updates Guidelines for Examining Unusual Patterns of Cancer and Environmental Concerns

Media Statement

For Immediate Release: Thursday, December 8, 2022
Contact: Media Relations
(404) 639-3286

The Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry (CDC/ATSDR) has released updated guidance to help state, tribal, local, and territorial public health agencies, and other partners as they investigate patterns of disease in communities, including cancer, and environmental concerns.

CDC/ATSDR conducted extensive scientific literature reviews and gathered comprehensive feedback via focus group sessions, meetings and interviews with community members, subject matter experts, and state, tribal, local, and territorial partners. The new guidance:

  • Places a greater emphasis on engaging and communicating with community members,
  • Recommends health departments consider proactive evaluation of cancer registry data at regular intervals to identify unusual patterns of cancer in a timelier fashion,
  • Replaces the steps in the 2013 Guidelines with new investigative phases and detailed criteria to:
    • address environmental concerns more broadly, and
    • de-emphasize statistical significance as the primary criterion for moving forward with evaluating unusual patterns of cancer.

Revising the guidelines was a component of Trevor’s Law, a section included in the Frank Lautenberg Chemical Safety for the 21st Century Act.  Funding to specifically revise the guidelines and associated work to support the development of them was included in the FY 2019-22 appropriations.  The new guidelines, as well as accompanying tools and templates, can be found at


CDC works 24/7 protecting America’s health, safety and security. Whether diseases start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.