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WATER GREMLIN PUBLIC. HEALTH ASSE55:MENT completeness and accuracy. Independent audits estimate completeness of the MCRS at over 99%. Cancer cases for the five census tracts in the White Bear Township, White Bear lake and Gem Lake area were identified from the MCRS for the most recent 10-year period for which complete data were available: 2007-2016. Five census tracts (040301, 040302, 040502, 040503, 040504) were used to identify residents who received a.new diagnosis of cancer in that period and resided.near the Water Gremlin facility in the area of analysis. When examining cancer rates in.a community or county with a relatively small population, the preferred approach is to compare the actual "observed" number of newly occurring cancers to the estimated "expected" number (calculated with the assumption that the community had the same cancer rates as some larger comparison population). For this analysis, cancer rates for the seven -county Twin Cities. Metro area during 2007-2016 were used for comparison to the census tracts. The "expected" number of cancers was estimated by applying Metro area cancer rates (by age and gender) to the population of the five census tracts from the 2010 census. Eighteen age categories were used to estimate expected cancer cases separately for males and females. Only the age and.gender distributions of the population are taken into account. when determining "expected" cancers since these important risk factors alone are known. However, other significant determinants of cancer risk such as smoking history, medical history, family history, obesity,.diet, occupation, reproductive history; infectious agents (e.g, human papilloma. virus, hepatitis viruses), or other established risk factors are unknown and cannot betaken into account. For ease. of comparison, the observed number of cancers divided by the expected number gives an observed -to -expected ratio (also called.the Standardized Incidence Ratio). If the two numbers were identical (which only rarely happens), this ratio would be I.00: If there were twice as many cancers as expected, the ratio would be..2.00; if there were half as many cancers as expected, the ratio would be 0.50. For each: such ratio, a 95% confidence interval was calculated and is also shown in this report: The confidence intervals representa range in which the ratio is expected to be 95% of the time; this means there is a 5% chance that the ratio could be outside the range. The confidence intervals give an additional measure of the variability and uncertainty that is encountered when examining cancer rates in a.cornmunity and comparing them to expected ra tes. If a confidence interval does not encompass a value of 1.00, the ratio is considered "statistically significant" - meaning that the difference is less likely to be due to random chance. However, there is still. some further uncertainty that is not reflected in the confidence intervals which do not take into account random differences which can be expected whenever multiple comparisons are made (e.g., comparing a large number of different types of cancer) or the effects of errors in estimatingthe population of the community. This report provides information about total cancers for. males and for females, as well as.20 specific types of cancers amongm ales and:22 types of cancer among females (representing about. 93%,of the total cancer incidence far each gender). 79