Cardinal News: Then & Now takes a look back at the stories we brought you over the last 12 months. Through the end of the year, we’re sharing updates on some of the people and issues that made news in 2025. This installment: Scott County families await the results of an investigation into a possible cancer cluster.
Since the state Health Department initiated an investigation into a potential cancer cluster in Scott County in April, at least four more children have been diagnosed with different types of cancer, according to Megan Smith, who has become the unofficial spokesperson for residents in the area.
Officials with the Virginia Department of Health say they expect to complete the data analysis and release it to the public by the end of the year. But the data used will not include the most recent surge in pediatric cancer cases due to a two-year data lag.
The state’s current review includes cases from 2015 to 2023. The cases that prompted parents to reach out to the Health Department began in 2024 and continued through 2025, Smith said. None of those recent diagnoses will be reflected in the state’s analysis.
Smith said she has documented 14 pediatric cancer cases in the last five years, including four diagnosed in October 2025. She’s pulled data from the Virginia Cancer Registry and developed a network in the community. Parents either reach out to her when there’s another pediatric cancer case, or she hears about it through others.
Most of the cancers are different types, with just a couple of repeats, according to Smith. A second child was diagnosed with Ewing sarcoma this year, a rare and aggressive bone cancer that mostly affects children, teens and young adults. The county has also seen a second case of neuroblastoma, which is a cancer of immature nerve cells.
A registered nurse for nearly two decades, Smith has spent her career caring for adults with cancer. She started digging into data about pediatric cancer in early 2025 when she heard that yet another family was starting treatment for a child. She met with families whose children had been recently diagnosed and compared local case rates to national studies.
Scott County has just over 20,000 residents. The National Cancer Institute reports a statewide childhood cancer incident rate of 14.8 per 100,000 people between 2017 and 2021. The 14 cases Smith has tallied would give Scott County a rate that’s about 4.7 times higher than the statewide average.
Learning about these rates drove Smith to become more vocal about pediatric cancer in her home county.
“It’s been one of the heaviest things I’ve done in my life,” Smith said.
To help carry the load, she formed a local task force of pediatricians, registered nurses and an emergency department physician. Together, they’ve worked to educate the community about early symptoms that may point to cancer.
Doctors and nurses in the area are also more aware, Smith said. Extreme fatigue or heavy legs could be a sign of disease; local clinicians are now more alert to those red flags, she said.
She has also taken on a public-facing role, advocating for parents who feel unheard and helping them navigate resources that might assist their families.
State review continues as residents wait for answers
The LENOWISCO Health District surveyed residents in April to collect more data for the state’s investigation. The district submitted the information in late July, and since then, a certified cancer analyst and other researchers with the state cancer registry have been processing it, said Dane De Silva, director of the division of population health data for the state health department.
To determine whether a cancer cluster exists, and whether environmental factors may be involved, analysts follow guidelines from the Centers for Disease Control and Prevention. They assess whether the number of cases exceeds expectations, whether the cancers are the same or related types, whether they occur within a specific geographic area or group of people and whether they emerge within a defined timeframe.
If the data suggests a cluster, environmental studies would follow. The CDC first published guidelines for investigating clusters of health events in 1990; Virginia has never confirmed a cancer cluster, De Silva said.
The two-year data lag exists because hospitals have six months to report new cancer diagnoses. Additional time is needed to reconcile records with other states when Virginia residents receive care elsewhere. Cancer Registry staff then verify and clean the data before submitting it to the CDC and the North American Association of Central Cancer Registries.
This timeline mirrors the national standard. However, some states are even further behind. In Tennessee, for example, the data lag is five years. Many Scott County residents, who live on the Tennessee border, receive care there.
State officials say they are open to conducting another analysis in a couple of years if this review does not warrant further investigation.
“We want the families to know that their voices, experience and questions do matter to us,” De Silva said. “We are committed to transparency, accuracy and compassion.”
Smith said the idea of waiting two more years for answers feels impossible. She’s started doing some independent monitoring of potential environmental factors, such as testing the water. But she also knows some families have moved away, others live in fear and many are still reeling from recent diagnoses.
She started reaching out to nonprofits that might help analyze data independently. The findings may not carry a state seal, she said, but she hopes it will keep the momentum going.
Professional basketball player Mac McClung, who is from Gate City, has started a donation fund for families of Scott County.
In a video posted Dec. 4, McClung said the funds will help the affected families pay for hotels and other costs of traveling to treatment facilities.