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Brain cancer isn’t the only cancer taking an unusual toll on Southern populations. Several forms of cancer strike Southerners more often than people who live in other sections of the country. Topping the list is lung cancer. Despite decades of warnings about the dangers of cigarette smoking, Southerners continue to smoke more than those in other regions of the country and, as a result, they are far more likely to be diagnosed with lung cancer.
Cancers of the mouth and throat also are linked to tobacco use, and once again those cancers are more prevalent in Southern states.
“Instead of cigarettes, it is the use of snuff and chewing tobacco – among women as well as men – that causes this spike in oral cancers,” according to William Blot, Ph.D., professor of Medicine. “There are still parts of the South, especially rural areas, where snuff use is fairly common among women.”
Behavior like tobacco use is clearly linked to the development of some forms of cancer. But it is less easy to explain why people living in the South are developing many types of cancer at higher rates than folks who live in other regions of the country. And it doesn’t explain why African-Americans are more likely to develop some forms of cancer and are more likely to die from the disease.
So Blot is leading the Southern Community Cohort Study (SCCS), the largest epidemiologic study in history to explore why the South has become the Cancer Belt and why African-Americans experience higher rates of many types of cancer. Starting with a $28 million grant from the National Cancer Institute, the SCCS hopes to recruit 90,000 people in 12 Southern states to learn about their lifestyles, their medical histories and their risk factors for cancer and other serious diseases. Two-thirds of the participants will be African-American and many will be from rural areas.
The SCCS is a collaborative project among Vanderbilt-Ingram, Meharry Medical College and the International Epidemiology Institute, as well as participating community health centers across the South.
“The study participants form one of the groups at highest risk for cancer that has ever been studied,” explained Blot. “Most other investigations have not included large numbers of African-Americans and few have included low-income individuals and people from rural parts of the country. This is the first large-scale study and the first in the South to include large numbers of all of those groups.”
All in the Family
The SCCS is designed to be a longitudinal study of this Southern population cohort. Each participant is interviewed and asked about their family background, medical history, diet, smoking habits and work environment. Every four years, researchers will do follow-up interviews, looking for new cancer cases or other diseases and trying to find the patterns of behavior, exposure to carcinogens or other clues that could explain why cancer is so prevalent in the region.
Alice Smith of Antioch, Tenn., was determined to sign up for the study when she visited the Matthew Walker Comprehensive Health Center in Nashville because cancer has forged a deadly legacy in her African-American family.
“Cancer took out the majority of the women on my mother’s side of the family, so whenever there is anything to do with cancer I always get involved,” she explained. Smith, 54, says her mother, grandmother, sister and several aunts were diagnosed with various types of cancer including breast, throat and pancreatic cancer.
“The doctors keep saying it’s hereditary, so I try to eat healthy and take care of myself,” said Smith. She also sees her doctor often, especially after she was diagnosed with multiple sclerosis. She hopes that her participation in the SCCS will help scientists determine the factors that contribute to so many serious illnesses in her own family and other families across the South.
“If they can figure out what’s causing it, they might be able to find some things you can do to prevent it,” Smith said with hope in her voice. “I’m very concerned about my health because I want to be here for a long, long time.”
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