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 |
| 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 |
| Viewing and Printing Hints | PDF Version |
| 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 |
| Viewing and Printing Hints | PDF Version |
|
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 |
| Viewing and Printing Hints | PDF Version |
| 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 |
*1996 data are preliminary. Source: New Jersey State Cancer Registry.