Cancer By County
Leukemia3-6

NJ Home Page DHSS Home Page Table of Contents


Background

Leukemias are a group of different malignancies in the bone marrow, the part of the body that makes blood cells. The bone marrow is replaced by immature white blood cells and abnormal numbers and forms of immature white cells appear throughout the body. The growth of normal blood cells is suppressed. There are five main types of leukemia - acute lymphocytic leukemia (ALL), chronic myelocytic or granulocytic leukemia (CML or CGL), acute myelocytic or acute nonlymphocytic leukemia (AML or ANLL), chronic lymphocytic leukemia (CLL), and adult T-cell leukemia (AT).

Risk Factors

The causes for most leukemias are unknown. Known risk factors include genetic abnormalities such as Down's syndrome, infection by human T-cell leukemia/lymphoma virus- I (adult T-cell leukemia), and certain types of chemotherapy drugs. People exposed to large doses of ionizing radiation in the past (such as X-ray treatment for children with a fungal infection or an enlarged thymus, for patients with ankylosing spondylitis, for cervical and uterine cancer, and for heavy menstual bleeding) were more likely to get leukemia. Also, people exposed to atomic bomb fallout in Japan and the first U.S. and British radiologists (who had no protection) were more likely to contract leukemia.

Workers exposed to the solvent benzene in the shoe, leather, rubber, petroleum refining, and chemical manufacturing industries have had excess leukemia. Excess leukemia has been found among farmers, perhaps from animal viruses or pesticides and other chemicals used in agriculture, and among press workers, printers, and painters. Some studies have found childhood leukemia related to parental occupational exposure to hydrocarbons, chemical or metal manufacturing, and other occupational exposures. Several studies have found that childhood leukemia was associated with pesticide exposure; this is being studied further.

Some earlier studies found an increased risk of leukemia among children residing close to high tension power lines (electro-magnetic fields), but later and better designed studies have not found an increased risk. A National Institute of Environmental Health Sciences Working Group which recently reviewed the research on extremely low frequency electromagnetic fields (ELF EMF) concluded that there is limited evidence that residential exposure to ELF EMF causes cancer in children.10 (Note: The term "limited" means that from the studies there is credible evidence of an association between an exposure and cancer but a causal link cannot be established with a high degree of certainty.)

Some studies of workers exposed to electromagnetic fields such as electricians, power line workers, and electronics workers also have shown an increased risk of leukemia, but other studies have not. Again, the National Institute of Environmental Health Sciences Working Group on ELF EMF concluded that there is limited evidence that occupational exposure to ELF EMF causes cancer.10 Smoking also may cause leukemia in adults; further studies are needed.

Prevention and Control

Preventing leukemia is difficult because the causes of most leukemias are unknown. Not smoking and reducing occupational exposure to benzene may reduce the risk of leukemia in adults. There is no routine screening test for diagnosing leukemia early.

Incidence and Mortality in the U.S.

There are an estimated 28,700 new cases of leukemia in 1998 for the U.S. It is more common among men than women and among whites than blacks. Leukemia occurs much more frequently in adults than in children, though it represents a much larger proportion of childhood cancers (a third) than of adult cancers (about two percent). Among children the most common type of leukemia is ALL, but among adults the most common types are AML and CLL. Sixty-three percent of leukemia patients survive at least one year and forty-two percent survive at least five years. About 21,600 leukemia deaths are estimated for 1998 in the U.S. Death rates due to leukemia have declined slightly among adults in the past twenty years. Childhood leukemia deaths have decreased much more, due to better treatment.

Incidence in New Jersey - 1986-1996

Tables 24 through 27 provide data on leukemia incidence by county for 1986 through 1996. Figure 10 depicts the trends statewide. Statewide, white men had higher rates than any other group except that in 1992 black men had a slightly higher rate than white men. For most years black men had higher rates than white women and for all the years black women had the lowest rates (see Figure 10). Individual counties followed a similar pattern, except black males had higher rates than white males in Salem county and black women had higher rates than white women in Burlington, Cumberland, and Middlesex counties (see Table 27). However, the rates for black men in Salem county and for black women in Cumberland county should be interpreted cautiously because they are based on small numbers. In general, the rates for white men, white women and black women declined slightly in the past few years statewide. The rates for black men fluctuated more than the rates for the other race/gender groups (see Figure 10).

Conclusion

Since the causes of most leukemias are unknown, research on the causes should continue. Also, not smoking and minimizing occupational exposure to benzene may reduce leukemia in adults.

Viewing and Printing Hints PDF Version

Table 24.
Leukemia Incidence
By County1, White Males, New Jersey - 1986-1996

COUNTY 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996
(Prelim.)

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

Atlantic

12

13.6

11

11.9

9

10.0

11

11.6

14

15.6

11

10.3

14

14.9

7

6.3

15

14.7

14

12.8

13

11.6

Bergen

56

14.4

77

18.0

75

17.1

60

13.6

63

14.7

76

18.3

58

13.5

54

12.7

49

11.3

53

11.8

56

13.1

Burlington

17

10.9

21

14.0

16

10.3

20

13.8

22

15.0

21

13.5

18

12.0

20

12.9

21

13.1

18

10.6

19

11.0

Camden

23

11.2

28

14.2

25

13.1

24

11.5

24

12.2

25

12.2

29

13.5

22

10.0

22

11.5

23

11.1

24

12.3

Cape May

---

---

5

8.8

---

---

5

9.0

10

16.5

6

10.0

6

10.8

10

15.7

7

12.1

7

11.1

6

9.8

Cumberland

12

20.9

---

---

8

14.2

---

---

14

24.9

8

12.7

8

13.4

9

16.0

7

11.0

7

12.8

---

---

Essex

35

13.0

43

16.0

46

17.8

44

18.0

40

15.7

42

17.4

30

12.1

35

14.8

35

15.2

36

15.0

30

12.5

Gloucester

15

18.1

13

14.9

14

17.2

12

15.0

8

9.1

11

10.0

18

19.1

13

12.1

9

8.7

17

16.6

10

10.1

Hudson

28

11.5

23

10.0

27

11.9

32

15.5

30

14.1

35

15.4

28

12.5

39

18.5

30

14.5

21

10.4

31

15.0

Hunterdon

8

20.4

7

14.7

---

---

---

---

11

25.8

8

17.0

---

---

7

14.2

6

11.6

5

11.8

7

13.1

Mercer

14

11.4

22

16.9

23

17.6

13

9.4

22

16.8

13

9.2

17

12.3

21

16.3

19

14.0

10

8.3

15

11.4

Middlesex

35

12.5

40

13.9

40

14.0

44

15.3

42

14.3

33

12.0

41

14.6

38

13.4

48

16.3

34

12.2

34

11.5

Monmouth

35

14.8

35

13.9

29

11.6

36

15.6

28

11.6

36

14.1

29

11.5

36

14.1

32

12.4

42

16.6

42

16.1

Morris

23

11.9

28

15.2

21

12.4

27

14.7

21

12.5

25

12.9

27

15.3

22

11.9

25

13.0

20

10.5

27

13.7

Ocean

28

9.7

51

19.7

33

11.9

49

17.6

49

15.2

47

17.2

40

11.2

44

14.5

41

11.8

39

10.9

37

11.4

Passaic

31

16.4

30

15.1

32

15.9

24

12.2

31

16.9

30

14.8

34

16.8

44

22.1

32

15.6

25

13.0

34

18.0

Somerset

22

23.4

19

20.6

9

8.7

15

14.6

17

15.3

9

8.0

12

11.5

14

12.8

16

14.2

15

13.6

13

10.9

Sussex

7

15.2

8

15.7

---

---

6

12.3

7

15.1

10

20.0

---

---

7

12.9

8

13.5

6

11.1

6

11.4

Union

26

10.2

42

18.2

22

9.9

35

16.5

38

17.0

33

13.8

23

10.2

21

9.7

27

11.7

24

10.1

29

13.5

Warren

8

18.8

---

---

12

28.7

5

12.2

8

18.5

7

14.8

7

15.3

10

20.9

9

20.0

7

13.6

9

19.6

STATE

442

13.2

512

15.0

457

13.6

475

14.1

504

15.0

492

14.2

449

13.0

476

13.8

463

13.1

432

12.2

449

12.8


1Incidence rates - per 100,000 males, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. Counties with six or more years of fewer than five cases each year were removed form the table - Salem county. The dashes indicate fewer than five cases. Source: New Jersey State Cancer Registry.

Viewing and Printing Hints PDF Version

Table 25.
Leukemia Incidence
By County1, White Females, New Jersey - 1986-1996

COUNTY 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996
(Prelim.)

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

Atlantic

9

7.2

13

10.5

11

10.3

9

6.5

9

5.7

10

5.9

12

8.9

9

6.2

10

8.5

9

5.6

8

5.8

Bergen

49

9.1

52

9.3

40

6.9

46

8.1

49

8.5

51

7.8

58

9.9

52

9.5

43

7.8

38

6.1

33

4.9

Burlington

11

5.7

10

6.0

9

3.8

13

6.4

12

5.5

10

4.6

16

7.8

18

8.4

15

7.3

12

6.5

9

4.7

Camden

22

9.1

28

9.4

23

9.1

19

7.0

25

9.8

24

8.8

16

6.6

23

8.7

19

6.8

12

4.5

21

9.4

Cape May

5

6.2

5

4.4

---

---

---

---

---

---

6

9.0

9

15.1

6

5.9

7

5.5

10

12.8

8

8.2

Cumberland

---

---

8

11.2

---

---

9

10.5

8

11.1

8

11.9

---

---

---

---

5

5.3

5

6.6

5

6.6

Essex

25

8.4

40

10.5

39

10.1

30

10.1

29

7.6

42

12.2

36

9.8

28

7.3

23

6.9

39

12.5

28

8.1

Gloucester

19

17.8

9

10.4

7

5.8

9

7.0

12

10.4

16

13.2

11

9.6

15

11.3

12

9.2

6

5.2

9

7.4

Hudson

26

6.6

19

5.7

23

7.4

26

8.1

28

9.2

26

7.8

30

9.0

27

9.3

34

10.8

26

7.8

23

7.5

Hunterdon

6

10.8

---

---

---

---

7

13.1

6

11.2

5

7.3

8

10.8

6

11.1

---

---

5

7.0

6

6.5

Mercer

13

7.4

11

6.8

16

8.8

17

9.1

17

8.5

12

6.8

16

8.6

21

10.6

12

7.4

18

9.3

20

10.9

Middlesex

33

10.5

25

6.8

31

8.4

28

7.4

26

7.6

31

9.6

29

7.8

36

9.9

25

6.2

32

7.3

31

8.9

Monmouth

29

9.4

25

7.1

25

7.5

35

10.8

34

9.3

24

6.6

33

10.6

25

5.8

26

7.4

29

9.5

27

8.0

Morris

16

6.3

13

5.2

28

12.8

14

6.5

20

8.2

23

10.3

14

5.5

26

10.5

21

8.5

17

7.2

19

8.1

Ocean

33

9.9

35

11.0

34

8.6

27

7.0

41

9.7

40

10.4

40

8.5

43

11.8

25

5.9

45

9.9

36

8.0

Passaic

13

5.6

29

10.9

33

11.7

30

12.0

24

8.4

21

7.6

25

9.3

34

14.3

30

11.4

25

10.1

30

12.5

Somerset

10

7.8

6

4.3

16

11.8

11

7.3

7

4.9

10

7.6

18

12.6

7

4.3

7

4.9

10

6.6

14

9.7

Union

24

6.4

28

9.6

20

5.9

31

9.6

32

8.7

26

7.8

29

8.2

31

8.7

17

4.3

21

6.5

16

4.8

Warren

7

15.2

6

9.8

7

9.8

10

18.0

6

10.3

7

10.4

7

10.1

7

13.9

5

7.0

7

8.5

---

---

STATE

367

8.4

370

8.3

379

8.3

387

8.6

399

8.5

401

8.6

418

8.9

422

9.0

345

7.4

373

7.8

357

7.8


1Incidence rates - per 100,000 females, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. Counties with six or more years of fewer than five cases each year were removed from the table - Salem and Sussex counties. The dashes indicate fewer than five cases. Source: New Jersey State Cancer Registry.

Viewing and Printing Hints PDF Version

Table 26.
Leukemia Incidence
By County, Blacks By Gender, New Jersey - 1986-1990 And 1991-19961

COUNTY

1986-1990

1991-1996

Male

Female

Male

Female

Number

Rate2

Number

Rate2

Number

Rate2

Number

Rate2

Atlantic

---

---

9

8.0

10

8.5

6

4.2

Bergen

9

10.3

7

6.2

8

7.3

12

8.2

Burlington

8

8.1

7

7.3

14

10.1

16

10.2

Camden

13

7.8

10

5.4

17

8.9

12

4.1

Cumberland

---

---

9

14.2

5

6.5

---

---

Essex

56

10.2

49

6.1

67

10.0

64

6.2

Gloucester

---

---

---

---

6

9.7

---

---

Hudson

15

10.4

11

5.9

11

7.3

19

8.1

Mercer

12

12.2

8

5.5

18

11.5

17

8.4

Middlesex

---

---

9

8.1

12

9.2

12

9.4

Monmouth

8

7.4

---

---

13

10.3

6

3.6

Passaic

10

11.3

9

6.5

16

13.9

7

4.2

Salem

---

---

---

---

5

15.5

---

---

Somerset

6

20.8

---

---

---

---

---

---

Union

16

9.3

8

3.7

25

11.1

14

5.0

STATE

175

9.4

147

5.8

235

9.7

204

6.0


1Incidence rates - per 100,000 population, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. Counties with fewer than five cases for each gender in each time period were removed from the table - Cape May, Hunterdon, Morris, Ocean, Sussex, and Warren counties. The dashes indicate fewer than five cases. Source: New Jersey State Cancer Registry.
2Average annual rate.

Viewing and Printing Hints PDF Version

Table 27.
Leukemia Incidence
By County, Race And Gender, New Jersey - 1986-1996 Combined1

COUNTY

MALE

FEMALE

WHITE

BLACK

WHITE

BLACK

Number

Rate2

Number

Rate2

Number

Rate2

Number

Rate2

Atlantic

131

12.1

14

7.1

109

7.4

15

5.8

Bergen

677

14.4

17

8.7

511

8.0

19

7.4

Burlington

213

12.5

22

9.2

135

6.0

23

9.0

Camden

269

12.0

30

8.4

232

8.0

22

4.6

Cape May

70

10.7

---

---

65

6.8

---

---

Cumberland

81

12.7

9

7.4

59

7.2

11

7.8

Essex

416

15.3

123

10.1

359

9.3

113

6.1

Gloucester

140

13.6

8

8.0

125

9.7

6

4.5

Hudson

324

13.5

26

8.7

288

8.1

30

7.3

Hunterdon

70

13.9

---

---

55

8.1

---

---

Mercer

189

13.0

30

11.6

173

8.5

25

7.2

Middlesex

429

13.6

15

7.4

327

8.3

21

8.9

Monmouth

380

13.8

21

9.1

312

8.4

10

3.4

Morris

266

13.2

---

---

211

8.0

---

---

Ocean

458

13.7

5

8.5

399

9.1

6

8.3

Passaic

347

16.1

26

12.9

294

10.3

16

5.2

Salem

43

12.3

7

13.2

41

9.2

---

---

Somerset

161

13.8

9

13.1

116

7.4

---

---

Sussex

71

12.3

---

---

54

7.7

---

---

Union

320

12.8

41

10.3

275

7.4

22

4.4

Warren

85

17.1

---

---

72

10.7

---

---

STATE

5151

13.6

410

9.5

4218

8.3

351

6.0


1Incidence rates - per 100,000 population, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. The dashes indicate fewer than five cases. Source: New Jersey State Cancer Registry.
2Average annual rate.

Figure 10.

Figure 10

*1996 data are preliminary. Source: New Jersey State Cancer Registry.