GRAND FORKS - Breast and prostate cancer remain the highest occurring cancers in North Dakota, according to recently compiled data from the state’s cancer registry.
Between 2012 and 2016 - the latest years for which cancer figures are available in the state - breast cancer was the most commonly diagnosed cancer among North Dakota women. For female breast cancer, the state reported a rate of 127 cases per 100,000 residents over that timespan. Cancers of the lungs and bronchus also were among some of the most common cancers in the state.
The North Dakota Statewide Cancer Registry determined that the state’s overall cancer rate for 2012 through 2016 was 445 cases for every 100,000 residents.
Cancer rates typically are calculated over a five-year period for a more accurate picture, and researchers usually report the rates 12 to 24 months after the fact because they need to verify and cross-check all the information, said Dr. Mary Ann Sens, chair of UND’s Department of Pathology.
“This stuff takes time to get accurate,” she said.
North Dakota’s 2012-16 rate was slightly below its own rate for 2011-15, when the state logged a cancer rate of 446 cases per every 100,000 residents. But Cristina Oancea, lead epidemiologist with the North Dakota Statewide Cancer Registry, urged caution in interpreting those numbers.
“We have seen a decrease in overall cancer incidence rates, although it’s not significant,” said Oancea. “What we are observing, though, when comparing North Dakota to the rest of the country is that we have higher prostate cancer incidents.”
For the 2011-2015 period, North Dakota’s prostate cancer rate was 121 cases per 100,000 residents. That compares to the nationwide rate of 109 cases per 100,000 residents.
Comparisons to U.S. figures over the 2012-16 period won’t be possible until nationwide data is publicly compiled and released, according to Oancea.
For 2011 through 2015, though, North Dakota logged a cancer rate of 446 cases per every 100,000 residents, putting it slightly above the nationwide average of 440 cases per every 100,000 people for the same time period.
As to why North Dakota’s prostate rate edges out the U.S. rate? That’s still unclear, but the massive migration of men moving to work the Bakken oil patch could provide a clue.
“We would need to dig more because, as we already know, we have seen an influx of people migrate to the state (starting in) 2007 due to the oil boom,” Oancea said. “It was mostly males coming in and finding jobs.”
To further complicate things, not all the folks who moved here for work claimed residence in North Dakota, and the cancer registry only takes into account North Dakota residents, Oancea noted.
Meanwhile, Minnesota’s cancer rate between 2011 and 2015 was slightly higher than the national average at 457 cases per 100,000 people. And as in North Dakota, prostate cancer also has been the most frequently diagnosed cancer among men in Minnesota, said Christina Nelson, who works with the state’s cancer screening program.
“The pattern we’re seeing in Minnesota is really no different than what we’re seeing in other areas of the country and most other states,” Nelson said.
Cancer rates also tend to be higher among men in both Minnesota and North Dakota. Researchers still are trying to understand why that could be. The answer may have something to do with sex chromosomes.
Women have two X chromosomes, while men have X and Y chromosomes. In basic terms, some research suggests that having two X chromosomes - as women do - could help fight cancer.
“It’s leading that way. I can’t say definitively, but it looks like it’s very promising,” said Nelson, noting that more research still needs to be done.
As for overall cancer rates in North Dakota and Minnesota, the prevalence of radon - a colorless, tasteless naturally occuring gas - may play a role. Researchers have observed higher levels of the gas in certain areas in both states.
Still, cancer is a complex condition, and it’s hard to pinpoint precise causes in all cases.
“It’s hard to talk in generalities with cancer,” said Jesse Tran, director of the comprehensive cancer control program with the North Dakota Department of Health. “Cancer isn’t one disease. It’s hundreds or thousands of different diseases.”
And perhaps no one understands that better than the folks working on the front lines of cancer treatment. Dr. Kevin Panico, a medical oncologist with Altru Health System for 13 years, said he works with several other medical professionals - surgeons, specialists, nurses, social workers and others - to best help cancer patients.
Panico also said he said staff will perform some initial tests to see what types of treatments would work best for an individual’s cancer.
“Cancer is often treated in what’s called a multimodality approach,” said Panico. That could include chemotherapy, medication or surgery.
As a medical oncologist, Panico administers oral or intravenous medications to patients with cancer. He spends most of his time helping patients at Altru’s Cancer Center on 960 S. Columbia Road, but he also spends three days each month tending to patients in nearby rural communities, he said.
That includes patients in Grafton, Park River, Langdon and Cavalier.
But whether in the city or more rural settings, treating cancer always requires a team effort, according to Panico.
“Cancer care is complicated,” he said. “There are lots of different providers, and we rely on each other to help focus on each person’s area so that patient gets the care they need.”
At the same time, there’s some hope for cancer prevention, too.
“The well-established research shows that upwards of 60 percent of cancer deaths … are associated with modifiable lifestyle risk factors, things like smoking, obesity, certain viruses, a sedentary lifestyle and alcohol consumption,” said Nelson with Minnesota’s cancer screening program.