Cancer Among 9/11 Survivors Is Accelerating 25 Years Later

Nearly a quarter-century after the collapse of the World Trade Center towers, the cancer burden among the civilians who lived, worked, or went to school nearby continues to climb. According to peer-reviewed data and recent reporting on the population still enrolled in 9/11 health programs, the rate of new diagnoses is only picking up speed.¹

A 2.5-Fold Jump in 5 Years

An updated analysis from the World Trade Center Environmental Health Center (WTC EHC), published in the International Journal of Environmental Research and Public Health, tracked cancer diagnoses among community members—as opposed to first responders—exposed to the disaster. These "survivors" include local residents, workers, students, and passersby who were caught in the dust cloud or exposed to the fires that burned through the end of 2001.¹

As of December 31, 2024, researchers had identified 17,449 individuals enrolled in the WTC EHC. Of those, 7274 had a certified cancer diagnosis. Excluding non-melanoma skin cancers, which are inconsistently captured in tumor registries, the study analyzed 6588 patients with 7643 distinct WTC-certified cancers. That case count has grown roughly 2.5-fold since the center's last full report in 2019—a pace the authors call a "major cancer burden" a quarter-century after the attacks.¹

“When we first started looking at cancers in this population … we thought, ‘Okay, you’d have [smoke] inhalation, and therefore what we were going to see was lung cancer,’” said Joan Reibman, an adjunct professor of medicine at NYU and another author of the study. “And instead, what we started seeing was all different cancers.”²

Women made up just over half the enrolled population and just under half of cancer patients. Breast cancer was the single most common diagnosis overall (22%), followed closely by prostate cancer (19%), then lung (8%), thyroid (6%), and colorectal cancer (6%). Among women, breast cancer accounted for half of all solid-tumor diagnoses; among men, prostate cancer made up nearly 40%. Blood and lymphatic cancers—lymphomas, leukemias, myelomas, and related disorders—represented another 13% of cases, with non-Hodgkin lymphoma the single largest subtype.¹

Two shifts stood out compared with the center's earlier data: skin melanoma and bladder cancer both climbed sharply up the rankings. Melanoma, once the eleventh most common among women and the tenth among men, now ranks sixth and fifth, respectively—a jump the authors describe as occurring over a "relatively short period" and one that warrants closer scrutiny given melanoma's known ties to environmental exposure.

Roughly 14% of patients developed more than 1 primary cancer, and the typical latency period—the time between exposure and diagnosis—clustered between 14 and 16 years, though many patients are now being diagnosed well beyond that window as the cohort ages.¹

The researchers caution that the numbers reflect a self-referred population under active medical surveillance, not a random sample of everyone exposed on 9/11—meaning the figures can't be used to calculate true cancer incidence or prove that WTC dust caused any individual case. Still, they point to a growing body of laboratory research suggesting biological plausibility: studies have linked WTC dust exposure to lasting epigenetic changes in blood and prostate tissue, increased mutation burden in blood-forming stem cells, and altered immune signaling—mechanisms that could help explain long-delayed cancer development.¹

A Program Under Strain as Need Grows

That rising caseload is landing on a health system already stretched thin. According to recent reporting, the number of 9/11 survivors receiving aid through federal health programs has roughly tripled in recent years, even as the programs charged with certifying and treating them have faced budget pressure and staffing reductions.^1,2

Taken together, the clinical data and the on-the-ground reporting point to the same conclusion: a quarter-century after the towers fell, the exposed community's cancer burden hasn't leveled off. Researchers say what's needed now is sustained, long-term surveillance, continued screening, and further study into the biological pathways connecting environmental exposure to cancers that can take well over a decade to surface—even as the program meant to catch and treat those cases faces new uncertainty.^1,2

What This Means for Pharmacists

Pharmacists, particularly those in oncology, specialty, and community settings in the New York metro area, are likely to keep encountering WTC-certified cancer patients well into the future, given that median latency still clusters around 14 to 16 years and diagnoses continue to climb.

A few practical takeaways from the data:

• Recognize the exposure history as clinically relevant. A patient's WTC exposure status can affect eligibility for coverage through the WTC Health Program, which certifies specific cancers tied to defined latency periods. Pharmacists filling oncology regimens for patients in this cohort should be aware that treatment costs and prior authorizations may route through this federal program rather than standard insurance.
• Watch for multiple primary cancers. With 14% of patients in the study developing more than one primary cancer, medication reconciliation and interaction checks are especially important for this population—sequential or concurrent cancer treatments raise the odds of complex regimens and cumulative toxicity.
• Stay alert to less common presentations. The rising prominence of melanoma and bladder cancer in this cohort means pharmacists should be attentive to counseling needs around newer immunotherapies and targeted agents used for these cancers, which may be less routine in a general oncology or retail setting than breast or prostate cancer regimens.
• Anticipate access disruptions. Reporting on staffing and funding cuts at the WTC Health Program suggests pharmacists may need to help patients navigate delays in prior authorization, recertification, or medication coverage and should be prepared to flag these issues to prescribers or care coordinators promptly.
• Support screening conversations. Given the emphasis researchers place on sustained surveillance, community and specialty pharmacists are well positioned to reinforce screening reminders (e.g., skin checks, colorectal and lung cancer screening) for patients who disclose a WTC exposure history, especially those aging into higher-risk windows.

REFERENCES

1. Durmus et al., "Evolving Cancer Characteristics Among World Trade Center Survivors: An Updated Analysis from the WTC Environmental Health Center," Int. J. Environ. Res. Public Health 2026, 23(5), 625;

2. The Washington Post, "Cancer's toll on 9/11 survivors is accelerating 25 years later," Sept. 9, 2026. Accessed September 9, 2026. https://www.washingtonpost.com/health/2026/09/09/cancers-toll-911-survivors-is-accelerating-25-years-later