World Trade Center Health Program adds uterine cancers to list of 9/11-related illnesses

All forms of uterine cancer, including endometrial cancer, have been added to the list of World Trade Center health conditions whose costs will be covered by the federal government — closing a significant gap in coverage for women who got seriously ill from the toxic dust at Ground Zero more than 21 years ago.

The World Trade Center Health Program on Wednesday issued a final rule in the Federal Register adding cancer of the uterus — the fourth-most-common form of cancer among women — to the list of 9/11-recognized illnesses. It's the 69th form of cancer to be covered by the program.

The rule change, which is effective immediately, allows program members with uterine or endometrial cancer who meet the eligibility and certification requirements to receive treatment, along with monitoring, cancer screenings and benefits counseling, with no out-of-pocket costs. They also will be able to seek compensation from the September 11th Victim Compensation Fund.

“This rule is significant as it not only provides access to lifesaving care and treatment, but also recognition for the women who sacrificed so much on and after 9/11 that their diagnosed uterine cancer is a WTC-related health condition,” said WTC Health Program administrator John Howard. “With the publication of this rule, a critical gap in coverage for women in the program has been eliminated."

The rule change, first proposed by the Centers for Disease Control and Prevention last May, followed a scientific review of the relationship between 9/11 exposure and uterine cancer. The change is expected to cost the health program between $1.7 million and $3.8 million annually from 2023 through 2026, the CDC said.

More than 21% of the 121,000 members enrolled in the WTC Health Program — about 26,000 in total — are women, according to the National Institute for Occupational Safety and Health.

They include Bay Shore native Lois Litvin, who developed severe respiratory illnesses, brain and uterine cancer, and acid reflux from the toxic debris at Ground Zero.

Litvin had just stepped off the subway in lower Manhattan on Sept. 11, 2001, heading for her job at the Occupational Safety and Health Administration, when she saw flames emerging from the south tower. 

"The ground shook then and the tower came down," recalled Litvin, 57, now of Clearwater, Florida. "The wall of dirt and soot started coming down the street. I ducked into a few different places [to hide] but thought they weren't good enough."

She eventually found shelter in a nearby deli, where she stuffed towels under the door to fend off the cloud of dust. 

Litvin's quick thinking kept her alive that Tuesday morning but was not enough to prevent her from getting seriously ill years later. Her medical treatments, including a hysterectomy to treat the uterine cancer, forced her to declare personal bankruptcy.

Sara Director, of the Manhattan law firm Barasch & McGarry, which represents Litvin, said a claim can now be made to the Victim Compensation Fund for medical expenses Litvin incurred before they were certified.

"This will have a monumental impact upon the 9/11 community," Director said. "For way too long, the female community was overlooked, understudied and under compensated. … This will allow, hopefully, for early detection. It will allow for proper treatment. It will allow for more scientific investigation."

The effort to include uterine cancer among covered conditions began when Iris Udasin, principal investigator for the WTC Health Program at Rutgers University, noticed several cases among first responders she was treating. Udasin and a colleague began studying the link and asked the federal government to make the change.

The Rutgers petition won support from doctors and researchers at New York University School of Medicine, Mount Sinai’s Icahn School of Medicine and Long Island's Northwell Health.

“We have spent more than two years working to get this approved," said Udasin, who serves as medical director of the Clinical Center at the Environmental and Occupational Health Sciences Institute at Rutgers. "And it will make a huge difference for the women who have developed this condition; the women who go on to develop this condition and all of their families.”

Litvin, who is now cancer-free, said the change was long overdue.

"It's so important because there weren't all that many women down there," she said. "It's only right that this should be covered."

By Robert Brodsky

robert.brodsky@newsday.com@BrodskyRobert

Robert Brodsky is a breaking news reporter who has worked at Newsday since 2011. He is a Queens College and American University alum.