9/11's Hidden Toll: Cancer Cases Among Survivors Now Outnumber First Responders

A Crisis That Did Not End on September 11

Twenty-five years after the Twin Towers fell, the attacks are still killing people — just more slowly, and in far greater numbers than most Americans realize. The number of 9/11 cancer victims has skyrocketed 1,680% over the past decade, fueled by rare variations of the disease, according to new statistics released as the 25th anniversary of the attacks approaches. The numbers are staggering, and they carry a grim warning: the worst of the health crisis may not yet be over.

Cancer certifications among Twin Tower survivors, downtown Manhattan residents, and workers on and near The Pile have exploded from 3,204 in 2015 to 57,044 this year, according to figures compiled by the World Trade Center Health Program. That is not a rounding error. That is a catastrophe unfolding in slow motion, one diagnosis at a time. "Sadly, we lose roughly two clients a day and see a new cancer certification every 50 minutes," said lawyer Michael Barasch, whose firm represents thousands of people enrolled in the World Trade Center Health Program.

Survivors Now Surpass First Responders in Cancer Cases

For years, the public face of 9/11-related illness has been the heroic firefighter or police officer who spent weeks digging through the rubble. That image, while accurate, has obscured a far wider public health emergency. For the first time, the number of cancer cases among survivors who resided, worked, or attended school near Ground Zero has surpassed the number of emergency responders — such as firefighters and police — who had prolonged exposure. Survivors account for 28,913 of the total cases — a 4,066% increase from the 694 cases reported in 2015 — while first responders account for 28,131, a difference of 782 cases.

While first responders were tracked in health programs almost immediately, many civilians were unaware for years that they were eligible for the same World Trade Center Health Program coverage. Ordinary people — office workers, students, parents pushing strollers through lower Manhattan — breathed the same air and had no idea they were accumulating a toxic debt that would come due decades later. One survivor captured it plainly: "For months afterward, you could taste the fuel in the air in the back of your throat and mouth. They kept telling us the air was safe. I don't think it was."

What Was in That Air

When the buildings fell and fires burned for months, thousands of tons of materials were pulverized and burned into a massive cloud containing over 70 known carcinogens, including asbestos, benzene, jet fuel, heavy metals, and pulverized glass and cement. This was not ordinary urban pollution. It was an unprecedented toxic event with no historical parallel, and its biological consequences are still being tallied. According to the CDC, the collapse of the Twin Towers "created massive dust clouds that filled the air and left hundreds of highly populated city blocks covered with ash, debris, and harmful particles, including asbestos, silica, metals, concrete, and glass," with an estimated 400,000 people exposed to toxic contaminants.

Data from the CDC through June shows that 67% of the 145,275 WTC Health Program members have been diagnosed with at least one of 69 cancers linked to 9/11 toxins — a rate significantly higher than the national average, which the National Cancer Institute estimates at around 40% for all Americans. The cancers are not limited to the lungs. There are 82 cases of cancer of the thymus gland, a small organ located in the upper chest behind the breastbone — tumors that represent fewer than 1% of all cancer cases nationally — and 591 cases of neuroendocrine cancers, which are uncommon tumors found most often in the pancreas, bowel, lungs, or adrenal glands.

The Long Shadow Ahead

The cancer surge is attributed partly to the advancing age of the population of Ground Zero responders and survivors, with most now in their late 50s, 60s, or early 70s — precisely the window when many cancers typically emerge. The number of certified cancers among WTC survivors has increased 2.5-fold over just the last five years, highlighting a major cancer burden as the 25th anniversary arrives.

The WTC Health Program is continuing a national awareness initiative urging anyone who lived, worked, went to school, or spent time in the New York City Disaster Area on September 11, 2001, or in the months that followed, to find out whether they may qualify for no out-of-pocket cost medical monitoring and treatment — because while many Americans associate the long-term health impacts of 9/11 with first responders, far fewer realize that children, students, residents, and workers were also at risk. The 25th anniversary this Thursday, September 11, will be a moment of national remembrance. For tens of thousands of people still receiving diagnoses, it is also something more personal — proof that September 11 never really ended.