My research delved into the possibility that perchlorethylene (PCE), and other volatile organic compounds (VOCs), spilled from the Joint Base of Cape Cod (previously known as Massachusetts Military Reservation, Otis Air National Guard Base) into the groundwater of upper Cape Cod, may be contributing to the area’s elevated breast cancer rates. Results demonstrate that the longer a woman lives on Cape Cod, the higher her risk for breast cancer. Significant breast cancer clusters appear around groundwater plumes known to be contaminated by VOCs, and remain even after adjustments for confounding factors. Results also show that one of the contaminated plumes drains into Ashumet Pond, where the catfish also have tumorous growths not seen in fish of the same species living in ponds with VOC levels within acceptable limits. Though the Air National Guard has made attempts at cleaning up the toxic waste, it has not addressed that their careless disposal of the waste caused up to 2,000 otherwise healthy women to develop breast cancer, with many still in the latent period. It is an injustice to the victims to make haphazard attempts to clean up the toxic waste with no apology or reparations given.

1. Perchloroethylene and cancer risk in Cape Cod, MA
Emmett Madeson
Department of Public Health Sciences, UMass Amherst
Study area
Methods
To begin, I collected prior research done on the subject
using the WorldCat library catalog and JSTOR. In total, I
found nine peer-reviewed studies and six government
sources. I then found shapefiles for my basemap that
were made publicly accessible thanks to the Cape Cod
Commission, Buzzards Bay Coalition, and MassGIS.
Using Google Earth, I traced CS-10 as well as the odds
ratio clusters discovered in the BU studies, then I
imported them into Arc to overlay onto my basemap.
One of the ways public health professionals calculate
the relationship between disease prevalence and toxins
is by using odds ratios. Odds ratios are calculated as
follows:
OR = (Exposed Cases x Unexposed Controls) ÷
(Exposed Controls x Unexposed Cases)
An odds ratio of 1.0 means that there is no causal
relationship between a toxin and a disease. An odds
ratio greater than 1.0 suggests a causal relationship
between a the toxin and the disease.
Time Resided in Cape Cod and Breast
Cancer
In a 2004 study that adjusted for confounding risk
factors such as age, socioeconomic status, family
history, and parity, it was found that women over 30
who had lived on the Cape for 20 to 30 years had an
increased incidence of breast cancer, when
compared to women of the same age who were new
to the area or who had moved away years before.
The results showed that women who had been living
in Cape Cod for 25 to 30 years had an OR of 1.72
while those less-exposed had an OR of 1.00,
meaning that women with 25 to 30 year residencies
on the Cape had 72% greater cancer incidence than
those who spent most of their lives off the Cape.
This study indicates that there is an environmental
health hazard, as with the removal of confounding
factors such as age, genetics, and socioeconomic
status, there is no other perceivable reason why
women living on the Cape would have higher breast
cancer incidence than those living off the Cape.5
Spatial Analysis of Residential Location and
Breast Cancer Incidence
Other studies applied spatial analysis to the current
and past residences of their subjects. The earlier
study found significant clustering in southwest
Falmouth, northwest Sandwich, and western
Barnstable.6 The later study related the clusters to
contaminated groundwater plumes around the Joint
Base of Cape Cod.7 Moreover, the latter study
further proved that the contaminated plumes were
to blame, because the clusters only appeared after
adjustment for latency and confounding factors.7
Water Filter Usage
A 2003 study linking PCE and breast cancer also found
that women who used water treatment devices in
their homes had significantly lower incidences of
breast cancer.10
Tumors in Brown Bullheads (Ameiurus
nebulosus) in Ashumet Pond
CS-10 drains into Ashumet Pond, where Brown
Bullheads are experiencing a similar cancer cluster.8 9
A 2006 study compared A. nebulosus from Ashumet
Pond with those in Great Herring Pond, which is
across the canal between Bourne and Plymouth.
Ashumet bullheads were found to have an 80%
prevalence rate of papillomas, whereas Great
Herring bullheads had a papilloma prevalence rate of
0%.8
Introduction
Since the 1980s, Cape Cod residents have suspected that a
breast cancer cluster exists in the upper portion of the
Cape. According to the National Cancer Institute,1 the
counties that make up the Cape and Islands region of
Massachusetts–Barnstable, Nantucket, and Dukes–hold
the top three breast cancer rates of all Massachusetts
counties. Massachusetts’ Silent Spring Institute, a local
organization that researches environmental hazards to
women’s health, has found that nine out of the fifteen
towns on Cape Cod have breast cancer rates at least 15%
higher than the state average.2
Scientists from the Boston University School of Public
Health and the Silent Spring Institute are currently looking
into the Joint Base of Cape Cod, a military base shared by
the Air National Guard, a Coast Guard Air station, and a
training facility called Camp Edwards. The Joint Base is
registered in the Environmental Protection Agency’s
Superfund program, meaning it’s a site with toxic waste.
Specifically, it was contaminated with the volatile organic
chemicals (VOCs) and known carcinogens
tetrachloroethylene (TCE) and perchloroethylene (PCE)
during missile testing sponsored by Boeing.3 The site also
just so happens to sit atop the Sagamore Lens, the sole
source aquifer serving the towns of Bourne, Sandwich,
Falmouth, Mashpee, Barnstable, and Yarmouth.3 4 This
project explores the possibility that PCE in the upper
Cape’s groundwater may be contributing to the area’s
elevated cancer rates.
Breast cancer odds ratios of study area
adjusted for 20 years of latency, superimposed
with underground plumes of PCE.7 8
Results
Discussion Conclusion
With the data from these studies combined, it is
undeniable that VOCs from JBCC are causing breast
cancer, and little further research is needed. The question
is, what is the National Guard going to do about it? The
AFCEE has partnered with the EPA to build water
treatment plants that extract contaminated water, treat
it, and release it back into the aquifer. But
mathematically, the dilution of a pollutant is asymptotic,
making achieving safe levels of VOCs always just out of
reach.11 Dilution an unattainable goal even without the
AFCEE having shut off numerous extraction wells
prematurely, including those that draw from CS-10, which
is projected to reach acceptable PCE levels in 2055.8
Surely the National Guard will issue an apology and give
some kind of reparations to the 2,000 breast cancer
patients in their own backyard. But with the AFCEE only
recognizing PCE as a carcinogen in 2008, twenty years
after the cancer cluster was first speculated, an
acknowledgement of the damage seems far away.12
Another solution would be to shut down JBCC so that
those who live and work there need no longer be
exposed. However, the addition of Barnstable County
Correctional Facility to JBCC in 2004, along with the 2016
proposal to house homeless Cape Codders on the site
hint at something perhaps more sinister.3 13
Moving forward, there are many different approaches to
make changes on the Upper Cape, through the media,
state legislators, and grassroots support of patients and
their families.
References
1 US Centers for Disease Control and Prevention, National Program of Cancer
Registries Cancer Surveillance System. (2016, November). State Cancer Profiles.
Retrieved from https://statecancerprofiles.cancer.gov/incidencerates.
2 Aschengrau, A., Paulu, C., & Oznoff, D. (1998). Tetrachloroethylene-
contaminated drinking water and the risk of breast cancer. Environmental
Health Perspectives, 106(Suppl 4), 947-953. doi:10.1289/ehp.98106s4947
3 Environmental Protection Agency. (2013). Otis Air National Guard Base/Camp
Edwards Falmouth, MA. Washington, DC: U.S. Environmental Protection Agency.
4 Belfit, G., & McCaffrey, D. (1996). Sagamore lens groundwater protection
project. Barnstable, MA: Cape Cod Committee.
5 McKelvey, W., Brody, J. G., Aschengrau, A., & Swartz, C. H. (2004). Association
between residence on Cape Cod, Massachusetts, and breast cancer. Annals of
Epidemiology, 14(2), 89-94. doi://doi.org/10.1016/S1047-2797(03)00120-0
6 Paulu, C., Aschengrau, A., & Ozonoff, D. (2002). Exploring associations between
residential location and breast cancer incidence in a case-control study.
Environmental Health Perspectives, 110(5), 471-478. doi:10.1289/ehp.02110471
7 Vieira, V., Webster, T., Weinberg, J., & Aschengrau, A. (2005). Spatial analysis of
lung, colorectal, and breast cancer on Cape Cod: An application of generalized
additive models to case-control data. Environmental Health: A Global Access
Science Source, 4(11), 18. doi:10.1186/1476-069X-4-11
8 Air Force Center for Engineering and the Environment. (2010). Groundwater
plume maps & information booklet. OANGB, MA: Massachusetts Military
Reservation.
9 Yang, X., Meier, J., Chang, L., Rowan, M., & Baumann, P. C. (2006). DNA damage
and external lesions in brown bullheads (ameiurus nebulosus) from
contaminated habitats. Environmental Toxicology and Chemistry, 25(11), 3035-
3038. doi:10.1897/05-706R.1
10 Aschengrau, A., Rogers, S., & Ozonoff, D. (2003). Perchloroethylene-
contaminated drinking water and the risk of breast cancer: Additional results
from Cape Cod, Massachusetts, USA. Environmental Health Perspectives, 111(2),
167-173. doi:10.1289/ehp.4980
11 DiGiulio, D. C., & Varadhan, R. (2001). Proposed approach for assessment of
performance and closure of venting systems. Development of recommendations
and methods to support assessment of soil venting performance and closure (pp.
1-5). Cincinnati: U.S. Environmental Protection Agency.
12 Ramaswamy, P., Alves, J., Davis, J., Forbes, R., Tindell, N., Dalrymple, J., . . .
O'Reilly, M. (2008). 3rd five-year review, 2002-2007, Massachusetts Military
Reservation, Superfund site, Otis Air National Guard Base. OANGB, MA: Air
Force Center for Engineering and the Environment.
13 Spillane, G. (2016, Aug 27). Plan to house homeless on Joint Base Cape Cod
criticized. Cape Cod Times.