title: Shale gas development and cancer incidence in southwest Pennsylvania.
abstract: OBJECTIVE
  To what extent does unconventional gas development lead to an increase in cancer incidence in heavily drilled Southwest Pennsylvania?
  
  
  METHODS
  Ecological study.
  
  
  METHODS
  Data for urinary bladder, thyroid and leukaemia were abstracted from the Pennsylvania Cancer Registry (PCR). Cancer incidence among counties with high, moderate and minimal number of producing wells is compared before drilling activity and thereafter. Observed vs expected cases, standardized incidence ratio and 95% confidence intervals are presented. Data are presented by county, diagnosis and sex for the years 2000-2004, 2004-2008 and 2008-2012. The percent difference between the observed cases from 2000 to 2004 and 2008-2012 was calculated.
  
  
  RESULTS
  The observed number of urinary bladder cases was higher than expected in both sexes in counties with shale gas activity. In counties with the fewest number of producing wells, the increase was essentially non-existent. The number of observed cases of thyroid cancer increased substantially among both sexes over the time period in all counties regardless of the number of wells drilled. The pattern for leukaemia was mixed among males and females and among the counties regardless of the extent of shale gas development activities.
  
  
  CONCLUSIONS
  Potential risk factors other than shale gas development must be taken into account to explain the higher than expected cancer cases in counties with and without shale gas wells before and during unconventional shale gas activity.
authors.affiliation: Professor of Healthcare Policy & Research and Director of the Office of Global Health Education Weill Cornell Medicine, 402 East 67th Street, New York, NY, 10065, USA. Electronic address: maf2011@med.cornell.edu.
authors.forename: M L
authors.initials: ML
authors.lastname: Finkel
mesh_terms: D019652:Extraction and Processing Industry / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007938:Leukemia / Q000453:epidemiology; D008297:Male; D059206:Natural Gas; D009369:Neoplasms / Q000453:epidemiology*; D010414:Pennsylvania / Q000453:epidemiology; D012042:Registries; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology
chemical_list: D059206:Natural Gas
keywords: Cancer epidemiology; Cancer incidence; Environmental epidemiology; Hydraulic fracturing; Unconventional shale development