A study of Baltimore cancer rates shows that the inner-city neighborhood near Lexington Market has the highest rate in the city, followed by an industrial stretch south of the harbor that includes Wagner's Point and Curtis Bay.
The area with the lowest cancer rate was Howard Park in far West Baltimore. Other areas that fared well were Lauraville in East Baltimore, Frankford in Northeast Baltimore and the adjoining neighborhoods of Hampden and Remington in North Baltimore.
At first glance, experts who conducted the study said, there is no clear pattern of environmental factors or lifestyle -- such as smoking or diet -- that would explain why some neighborhoods are hit hard and others are not. While many health problems are linked to economic levels, the cancer study did not find a pattern of high rates in the poorer neighborhoods and low rates in wealthier areas.
"In fact, a lot of the trends suggest that poverty is not a dominant factor," said Dr. Jonathan Samet, an epidemiologist with the Johns Hopkins School of Public Health who directed the study.
The cancer rates in Baltimore are higher than those in Maryland and the nation overall, but there are wide disparities within the city. In conducting the study, researchers determined the cancer rates in each of the city's 30 ZIP codes. They also found the rates for 12 kinds of cancers as well as for separate demographic groupings -- black men, black women, white men and white women.
Samet warned that the findings represent only a snapshot of what existed from 1992 to 1995 -- the most recent data that were available from the state cancer registry -- and don't necessarily suggest a longtime trend.
One problem is that the population in some ZIP codes is low --21227 includes only a tiny corner of Baltimore and had just 79 city residents -- so the chance occurrence of a few extra cancer cases could cause the rate to surge. It's also difficult to compare sparsely populated neighborhoods with denser areas, where the ZIP code population could include 70,000 people.
"You have to be very careful but it provides a look," Samet said of the study. He pointed out that the Wagner's Point ZIP code, for instance, has only 3,600 people, a relatively small sample.
The area with the highest cancer rate, the 21201 ZIP code, includes the neighborhoods around Lexington Market and the University of Maryland Medical Center, as well as several blocks west of Martin Luther King Boulevard.
Several community leaders said they were surprised to hear the neighborhood was so affected by cancer. But Margaret Harris, 60, president of the Orchard Mews Tenant Association, said she wasn't shocked.
"Some people don't eat right. Some people smoke too much. They do a lot of things against their health," Harris said. Because her mother, aunt and sister all died from cancer, Harris is vigilant, watching her diet and getting routine tests.
The study was requested by city Health Commissioner Peter Beilenson after residents of Wagner's Point, an isolated neighborhood in southern Baltimore encircled by chemical plants, said the disease was killing residents at an alarmingly high rate. Many suspected that the culprit was fumes from factories and diesel trucks that deliver supplies.
Beilenson said the study did find high cancer rates in Wagner's Point, but not in nearby Brooklyn where activists also voiced concerns about the effects of industrial pollution. Wagner's Point activists who persuaded the city to relocate residents to safer places last year said the study confirms their suspicions -- though some expected the results to be worse.
"I thought we were No. 1," said Rose Hindla, who moved from Wagner's Point to Glen Burnie in August. "It surprises me we're No. 2."
Doris McGuigan, a Brooklyn activist who joined in the fight against industrial pollution, said she remains convinced that residents are being hurt more by the air they breathe than anything they are doing to themselves.
"You can't tell me that people in this area smoke more than in Cherry Hill or other areas of South Baltimore," she said. "We have an excess of cancer because of all the industry here."
Beilenson, however, said it was not clear that pollution was more to blame than smoking. He said he hoped to find money for another study that would determine whether people in high-cancer areas are exposed to particular carcinogens.
In many cases, neighborhoods that ranked high were affected by different cancers, suggesting that the risk factors vary.
To rank highest overall, the Lexington Market area ranked first in lung, digestive (colon, esophageal and stomach) and skin cancer -- but relatively low in breast, bladder and prostate cancer.
The Wagner's Point-Curtis Bay ZIP code ranked high in lung cancer, but also in leukemia, urinary, female genital and breast cancers.
Digestive cancers, however, were relatively few.
The ZIP code that includes affluent Mount Washington ranked sixth overall in cancer, owing partly to its third-place ranking in breast cancer.