The Centers for Disease Control and Prevention (CDC) (2013) defines cancer clusters as a greater-than-expected amount of similar cancer cases occurring at a given time moment between members of a defined community. Tumor clusters present many challenges due to the complexity of the analytical process and the abundance of questions and concerns. Because research and studies of cancer clusters in the United States have uncovered few conclusive determinants, many states are hesitant to devote excess resources and money to meticulous trials. Viewing the issue of uncovering potential environmental hazards as a priority, Maryland is employing a specially appointed working group to process all community concerns to force serious deliberation and thorough investigation of problem sites across the state (Department of legislative services, Office of Information Systems [DLSOIS ], 2013). With rising cancer rates emerging in communities across the United States, the CDC announced guidelines for examining clusters of healthcare incidents in the 1990s (Kingsley, Schmeichel, & Rubin, 2007). These guidelines were not disease specific or heavily enforced, but served as a model for state, local, and community health departments to expand and improve protocols for inspecting suspected cancer clusters (CDC, 2013). According to the 1990 CDC Guidelines, a four-step approach was adapted to observe questionable clusters: “initial response, evaluation, major feasibility study, and etiological investigation” (2013). Throughout the United States, community concern about potential cancer clusters is relatively high, with over 1,100 annual inquiries to each state's health department (Trumbo, McComas, & Besley, 2008). Acco...... half of the paper...... on cancer clusters. Retrieved from the Maryland Cancer Registry website: http://phpa.dhmh.maryland.gov/cancer/Documents/Questions and Answers About Cancer Clusters.pdfPenberthy, L., Gillam, C., Ginde, G., Mccclish , D., Pace, S., Grigio, L., . . . Radhakrishnan, S. (2012). Hematological malignancies: an opportunity to fill a gap in cancer surveillance. Causes and Control of Cancer, 23(8), 1253-1264. doi:10.1007/s10552-012-0003-1Trumbo, C. W., McComas, K. A., & Besley, J. C. (2008). Individual- and community-level effects on risk perception in cancer cluster investigations. Risk Analysis, 28(1), 161-178. doi:10.1111/j.1539-6924.2008.01007.xYang, M. (2011). A current global vision of environmental and occupational cancers. Journal of Environmental Science and Health. Part C, Environmental Carcinogenesis and Ecotoxicology Reviews, 29(3), 223-249. doi:10.1080/10590501.2011.601848