Site specific cancer incidence in the Republic of the Marshall Islands

Abstract

There is a paucity of data about cancer in the Republic of the Marshall Islands (RMI), a former U.S. Trust Territory. This study provides the first comprehensive data analysis on the incidence rates for certain cancers in the RMI. The Nuclear Claims Tribunal (NCT) of the RMI provided archival data on all decedent requests that were presented for personal injury compensation through December 16, 1996. Medical records of these individuals were reviewed to obtain information to determine cancer incidence. Age-adjusted incidence rates by site and gender were calculated and compared with U.S. rates. There were significant differences in the age-adjusted, site specific cancer incidence rates during the period from 1985 to 1994 between the RMI and the United States. The RMI had higher age-adjusted incidence rates for lung (m = 3.8x, f = 3x), cervix (f = 5.8x), gastrointestinal tract (m = 1.9x, f = 8.5x), liver (m = 15.3x, f = 40x), breast (f = 1.4x), urinary tract (f = 5.8x), oral (m = 3.4x, f = 1.5x), and thyroid (f = 7.2x) cancers. The RMI NCT data provided base-line information that has important implications for future cancer prevention and control in this population. The calculated incidence rates are alarming, because these rates are probably under- estimations of the true cancer incidence rates. Contributing factors to the higher incidence rates may include environmental and life-style factors, such as radiation exposure, alcohol and tobacco abuse, vitamin A deficiency, and high rates of hepatitis B and sexually transmitted diseases. Further investigations into cancer rates and factors associated with increased incidence in the RMI are necessary.