Where does Marin, once home of the worst breast cancer rate in the world, stand now?
I've been waiting a year for yet another shoe to drop.
That, I learned long ago, is what happens with almost every bit of research, but especially those concerning breast cancer.
Flip-flopping in the cancer industry has become de rigueur.
The most recent shoe drop came at the tail of 2015 when a then-new report indicated breast cancer rates in Marin County — which previously had been believed to be a cluster of the disease — had plummeted to their lowest level since tracking began in '88.
That decreased rate, a county report had noted, matched (instead of topping) the statewide average.
That study, of course, contradicted earlier reports dating back to the first fallen clodhopper in 1994. The Marin rate then was called the highest in the world, according to a study by the Northern California Cancer Center (since renamed the Cancer Prevention Institute of California).
Marin's rate actually peaked in 2001, when the numbers for non-Hispanic white women had climbed 60 percent.
Since that year, it's dropped 31 percent.
Well, risk factors for Marin's white women have been listed as outgrowths of their being affluent — including higher alcohol consumption and the delayed age of childbearing, not necessarily in that order.
And, until 2002, a heightened use of hormone therapy (especially an estrogen/progestin combination).
When those hormones were abandoned as treatment, the cancer rates began to descend.
Despite the obvious connection, few would risk verbally pinpointing why the severe dips had occurred — or why the rates had actually been so high in the first place.
Dr. Mary Mockus, a principal researcher with the Marin Women's Study, long-term, county-led breast cancer research involving nearly14,000 women, did say she thought earlier detection and increased patient awareness had helped.
At the same time, authors of the study discounted any influence changes in mammography screenings might have had.
That research organization, not incidentally, won a reprieve last year after my adopted home county chose not to finance additional work.
Dr. Mark Powell of Greenbrae rescued it by leaning on crowdfunding and the Avon Foundation — and partnering with several groups, including Zero Breast Cancer, a Marin nonprofit headed by Rose Barlow that I wholeheartedly endorse.
Still, there's been no updates from the researchers recently, so I wait.
And wait. And wait.
I have a vested interest in knowing if there's a root cause in Marin — monolithic or not — because here's where my wife was diagnosed with the disease more than two decades ago.
Meanwhile, frequent flip-flopping results stemming from cancer research are well documented in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at caregivers.