42 U.S.C. § 280g–17 — Designation and investigation of potential cancer clusters

(a) Definitions: A "cancer cluster" is the incidence of a particular cancer within a population group, geographic area, and time period that is greater than expected for that group, area, and period. "Particular cancer" means one specific cancer type, or a group of cancers scientifically proven to share a cause. "Population group" means a group -- for calculating cancer rates -- defined by factors like race, ethnicity, age, or gender. (b) Criteria for designation of potential cancer clusters: (1) The Secretary must develop criteria for designating potential clusters. (2) Those criteria must consider, as appropriate, (A) a standard for identifying and reporting cancer clusters, used to determine when incidence is greater than typically observed; (B) scientific screening standards ensuring a cluster involves the same cancer type or types; (C) the population affected, by factors like race, ethnicity, age, and gender, for calculating rates; (D) drawing the geographic area's boundaries so as not to create or hide a potential cluster by how the area is chosen; and (E) the time period over which cases are counted or an expected number of cases is calculated. (c) Guidelines for investigation of potential cancer clusters: The Secretary, consulting the Council of State and Territorial Epidemiologists and State and local health department representatives, must develop, publish, and periodically update guidelines for investigating potential clusters. The guidelines must (1) recommend that investigations (A) use the criteria from subsection (b); (B) use the best available science; and (C) rely on a weight of the scientific evidence; (2) provide standardized ways to review and categorize data, including from health surveillance systems and cluster reports; and (3) guide the use of proper epidemiological and other approaches. (d) Investigation of cancer clusters: (1)(A) The Secretary, consulting relevant State and local health departments, must consider whether investigating a potential cluster is appropriate; and (B) in conducting investigations, has discretion to prioritize certain clusters based on available resources. (2) The Secretary must coordinate with HHS agencies and other federal agencies, such as the EPA, when investigating. (3) The Secretary must rely on all appropriate biomonitoring information collected under other federal programs, such as the National Health and Nutrition Examination Survey, and may give technical assistance for related biomonitoring studies by other agencies. (e) Duties: The Secretary must (1) make sure HHS staff are prepared to give timely help, as practicable, when a State or local health authority requests a cluster investigation; (2) keep staff expertise in epidemiology, toxicology, data analysis, environmental health and cancer surveillance, exposure assessment, pediatric health, pollution control, community outreach, health education, laboratory sampling and analysis, spatial mapping, and informatics; (3) consult with community members during investigations, as the Secretary determines appropriate; (4) collect, store, and share reports on cluster investigations, their possible causes, and actions taken to address them; and (5) give technical assistance for cluster investigations to State and local health departments through existing programs, such as the CDC's Epi-Aids program and the Agency for Toxic Substances and Disease Registry's Assessments of Chemical Exposures Program.