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Marines use statistics to fight image war over cancer cluster

Fifty-three men with ties to the Marine Corps' Camp Lejeune have been diagnosed with a rare form of breast cancer. That, some say, is proof that polluted drinking water at the North Carolina base caused their illnesses.

The cancer cluster has put the Marines increasingly on the defensive. The result is a war of cancer statistics, with the Marines telling some reporters that the number of cases is far below what you would expect, given how many men have lived at Lejeune.

To critics, that reasoning is not only bad science, it underplays the threat to men who should be more vigilant for signs of breast cancer.

"People have a right to know they may be at risk," said Devra Davis, a University of Pittsburgh Cancer Center epidemiologist who has worked on the cluster.

"The truth has been compromised by the Marine Corps' public relations push," she said.

Questionable math

Mike Partain, a Tallahassee resident and breast cancer survivor, identified the cluster by networking with other male breast cancer patients around the nation. So far, 53 men or surviving family members with ties to Lejeune have come forward.

"It seems to be on its face a baffling number," said Richard Clapp, an epidemiologist at Boston University.

The National Cancer Institute says that from 1975 to 2006, just one case (actually, 1.09) of breast cancer occurred for every 100,000 men, according to a sample of the U.S. population.

That adds up to four cases in a population of 400,000, which is the Corps' estimate of the base's male population between 1957 and 1987, when its water was polluted by solvents.

But the Corps has told at least two major news networks it believes about 400 cases of breast cancer could be expected statistically in the base's population over those three decades. The Corps refused to discuss the male breast cancer cluster in detail when the St. Petersburg Times asked about the estimate.

'Clearly wrong'

So, where did the Marines' figure of 400 come from?

The American Cancer Society says men have a 1-in-1,000 lifetime chance of breast cancer.

In its communications with CNN, the Corps appears to have taken that 1-in-1,000 statistic to conclude that in a population of 400,000 men, 400 would be expected to get breast cancer.

"Might want to . . . consider this aspect in future reporting," Maj. Eric Dent, a Corps spokesman, told CNN in an Oct. 8 e-mail.

But given that fewer than 2,000 cases of male breast cancer are diagnosed every year, the math is more complicated.

"What the Marines are doing is clearly wrong," said Clapp.

Clapp said the 1-in-1,000 figure is the risk in a population of men living to age 95 and cannot be applied to the general population.

"The 400,000 at Camp Lejeune were mostly young men," Clapp said.

Indeed, male breast cancer is typically an old man's disease.

Clapp noted that of the 13,132 male breast cancer survivors alive as of 2006, well more than half – 7,093 — were over the age of 70, according to National Cancer Institute figures. Just 640 of those 13,132 were under age 50.

The majority of the 53 cases found so far involve men diagnosed before age 70, said Partain, who was 39 when diagnosed.

While the incidence of male breast cancer is increasing across the nation — from 0.9 Florida cases per 100,000 in 1990 to 1.5 by 2000 — the numbers at Lejeune still appear surprisingly high, epidemiologists say.

But they caution the 53 figure by itself proves nothing and say more study needs to be done before those cases can be linked to an environmental cause.

"You can't say anything from a raw number," said Eric Mintz, an epidemiologist from Canada. "I'm not pooh-poohing the number. But these things are quite difficult to investigate."

Contract stop urged

Statistics aren't the only tool the Marines are using to defend Lejeune's image.

On Friday, the Times revealed that the Corps had entered into a $600,000 contract with the National Research Council on May 1. That was a month before the council released a report saying science could not link the disease to polluted water.

The Marine Corps touted the finding with the 145,000 former Camp Lejeune residents — including more than 12,000 Floridians — on a Corps health registry of those exposed to the water. But the Corps didn't reveal that it was paying the council.

Rep. Brad Miller, D-N.C., sent a letter to the research council Tuesday asking it to withdraw from the contract. Council officials declined to comment.

Davis, the epidemiologist at the University of Pittsburgh Cancer Center, said the Corps should be getting word out to former Marines that they may be at higher risk of cancer, not promoting misleading numbers.

"Statistics are complicated," Davis said. "But just because they are complicated doesn't mean they should be misused."

William R. Levesque can be reached at levesque@sptimes.com or (813) 226-3432.

Marines use statistics to fight image war over cancer cluster 11/11/09 [Last modified: Thursday, November 12, 2009 1:07am]
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