Residential proximity to nuclear power plants and cancer incidence in Massachusetts, USA (2000-2018).

PURPOSE: To investigate the associations between residential proximity to nuclear power plants and ZIP code-level cancer incidence among Massachusetts residents.

METHODS

We assessed proximity of Massachusetts ZIP codes to nuclear power plants using an inverse-distance weighted metric. We obtained cancer incidence data (2000-2018) from the Massachusetts Cancer Registry. We applied two approaches: (1) longitudinal Generalized Estimating Equation (GEE) Poisson regression to evaluate yearly incidences for all cancers combined, and (2) cross-sectional log-linear Poisson regression for site-specific cancers. We adjusted models for PM2.5, demographic, socioeconomic, environmental, and healthcare covariates, and stratified analyses by sex and four age groups (45-54, 55-64, 65-74, 75 +).

RESULTS

Proximity to plants significantly increased cancer incidence, with risk declining by distance. At 2 km, females showed RRs of 1.52 (95% CI: 1.20-1.94) for ages 55-64, 2.00 (1.59-2.52) for 65-74, and 2.53 (1.98-3.22) for 75 + . Males showed RRs of 1.97 (1.57-2.48), 1.75 (1.42-2.16), and 1.63 (1.29-2.06), respectively. Cancer site-specific analyses showed significant associations for lung, prostate, breast, colorectal, bladder, melanoma, leukemia, thyroid, uterine, kidney, laryngeal, pancreatic, oral, esophageal, and Hodgkin lymphoma, with variation by sex and age. We estimated 10,815 female and 9,803 male cancer cases attributable to proximity, corresponding to attributable fractions of 4.1% (95% CI: 2.4-5.7%) and 3.5% (95% CI: 1.8-5.2%).

CONCLUSIONS

Residential proximity to nuclear plants in Massachusetts is associated with elevated cancer risks, particularly among older adults, underscoring the need for continued epidemiologic monitoring amid renewed interest in nuclear energy.