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- Ignores the Precautionary Principle
- “Blames the Victim”
The cancer establishment has long insisted that faulty lifestyle, particularly smoking, inactivity, and fatty diet—excluding recognition of its contamination with carcinogenic pesticides—is the predominant cause of cancer. This exclusionary or predominant lifestyle emphasis, also known as "blame the victim," remains strongly reinforced by U.S. and international reliance on the biased and inept 1981 report on U.S. cancer mortality by U.K. epidemiologists, Drs. Richard Doll and Richard Peto (13); over the last three decades, Doll's track record on prevention reveals strong pro-industry bias and conflicts of interest (Appendix VII). In the absence of any scientific data, Doll and Peto guesstimated that lifestyle factors are responsible for up to 90% of cancer mortality. This left a balance of 5%, which they arbitrarily assigned to occupation, pollution, and "industrial products." Strangely excluded from their 1981 guesstimates was any consideration of mortality for people over the age of 65 and blacks, just those groups among whom cancer disproportionately impacts; also excluded was any consideration of cancer incidence. Further excluded was recognition of the substantial evidence that a wide range of occupational carcinogens are major causes of many cancers, particularly lung (12); there is also clear evidence of additive or synergistic interactions between carcinogenic occupational exposures and smoking. Moreover, "non-smoking attributable" exposures, occupational and air pollution, are responsible for about 20% of lung cancers (10). Nevertheless, NCI and ACS continue to direct minimal research and emphasis on occupational and environmental causes of cancer, in spite of substantial data relating them to the escalating incidence of overall and site-specific cancers.
The ACS is even more dismissive than the NCI in its understanding and priorities on cancer prevention. In Cancer Facts and Figures 2002, ACS reassures that cancer risks from dietary pesticides, hazardous waste sites, ionizing radiation from "closely controlled" nuclear plants, and non-ionizing radiation are all at such low levels as to be "negligible."
The cancer establishment's continued trivialization of the major impact of occupational cancer is egregious. Based on NIOSH surveys, some 11 million men and 4 million women are involuntarily exposed to a wide range of occupational carcinogens, representing the single largest cause of avoidable cancer. A 1979 confidential report by consultants to the chemical industry trade association (the American Industrial Health Council) admitted that exposures to occupational carcinogens were responsible for at least 20% of all cancer, and that they posed a "public health catastrophe" (14). Although this report was widely leaked, it was ignored by Doll and Peto (13). A more recent limited and conservative estimate concluded that occupational exposures overall are responsible for 10% of cancer mortality, about 55,000 avoidable annual deaths (15); for workers exposed to highly potent carcinogens, mortality rates are much higher. Poorly recognized is the doubling and quadrupling of the incidence of mesotheliomas, uniquely induced by asbestos, in white and black men, respectively, from 1977 to 1999 (1). Additionally, paternal and maternal exposures to occupational carcinogens have been incriminated as significant causes of childhood cancer, the overall incidence of which has increased by 26% since passage of the National Cancer Act (Appendix II). It should be further stressed that lower level exposures to occupational carcinogens, such as asbestos and benzene, often extend from within industrial plants to local communities and, to a lesser extent, the entire U.S. population.
NCI Rejects the Precautionary Principle
The U. S. National Cancer Institute ignores the fundamental and world-wide acceptance of the Precautionary Principle. Illustratively, it has failed to undertake research on nationwide community concerns on clusters of adult and childhood cancers in the vicinity of major air polluting urban facilities, nuclear power plants, petrochemical industries, and Superfund hazardous waste sites; these are disproportionately and discriminatorily located in low socio-economic, African-American, and other ethnic communities. This failure is further compounded by the availability of data on air and water pollutants from large chemical industries and hazardous waste sites, following EPA's creation of The National Toxic Release Inventory (TRI) in 1987. More detailed and user-friendly Right-to-Know exposure data at the state level, particularly in Massachusetts and New Jersey, are now available (16). Worse still, both NCI and ACS have remained silent or dismissive of such concerns. Furthermore, NCI's silence fails to reflect substantial data incriminating avoidable and unknowing exposures of the population-at-large to industrial carcinogens, particularly Persistent Organic Pollutants (POPs), and novel man-made radioactive isotopes which contaminate the totality of the environment: air, water, soil, the workplace, and consumer products, such as food, household products, cosmetics and toiletries. Such exposures have, to varying degrees, been incriminated in the escalating incidence of overall and site-specific cancers over recent decades.
A further example of NCI's dismissiveness of avoidable causes of cancer is the insistence by Dr. Richard Klausner, NCI Director from 1995 to 2001, at Congresswoman Nancy Pelosi's (D-CA) July 26, 1996, Fort Mason, San Francisco “Town Hall Meeting” on breast cancer, that exposure to “low level diagnostic ionizing radiation does not demonstrate an increased risk.” However, this is contrary to the August, 2000 conclusion of NCI’s own three senior staffers involved in the U.S. Scoliosis Control Study (Drs. M. Doody, J. Lonstein, and C. Land), that the allegedly relatively low cumulative breast dose involved was responsible for a 70% excess breast cancer mortality.
NCI's minimal priorities for primary prevention research and dismissal of the Precautionary Principle are further exemplified by its trivialization of the significance of evidence derived from valid carcinogenicity tests in rodents; the ACS is even more dismissive. Illustrative is the September 1992 statement by Dr. Richard Adamson, past director of NCI's Division of Cancer Epidemiology, trivializing the risks of food contaminated with pesticides shown to be carcinogenic in validated rodent tests; as Director of the Washington office of the National Soft Drinks Association, Adamson promotes the use of artificial sweeteners, particularly the carcinogen saccharin. Further illustrative is the June 1995 dismissal by senior NCI staffer Dr. Leslie Ford of the well-documented evidence on the potent hepatocarcinogenicity in rats and formation of irreversible DNA adducts of Tamoxifen used in breast cancer chemoprevention trials in healthy women (17). She dismissed this evidence, of which women still remain uninformed, as "premature," claiming that carcinogenic effects were seen only at "high doses," although these were similar to those used in the trial. Ford further attempted to discredit this evidence on the remarkable grounds that no women in the trial had developed liver cancer over the preceding few years. The same logic would have eliminated most unequivocal carcinogens, such as asbestos, benzene, and vinyl chloride, which rarely, if ever, induce cancer with such brief latency.
In striking contrast to the NCI and ACS, in February 2002, the Canadian Cancer Society has unequivocally affirmed the Precautionary Principle "to develop our cancer prevention and risk reduction messages." However, in its September 2001 "Discussion Document," the Canadian Government effectively rejected this Principle, as recently criticized by the Canadian Environmental Law Association, in favor of a cost-benefit and scientific risk-based framework.
In further explicit support of the Precautionary Principle, the Canadian Cancer Society joined with the Sierra Club of Canada in April 2002 in demanding a ban on the "cosmetic" use of carcinogenic pesticides in the home, garden, lawn and recreational facilities (18). However, the Minister of Health, Anne MacLellan, rejected this demand, claiming that "there is no evidence to support such a case. Pesticides are registered only if their risks have been determined to be acceptable when used according to instructions." In striking contrast, Quebec’s Minister of the Environment presented a new pesticide management code in July 2002 “with strict regulations designed to progressively institute a decreased and more prudent use and sale of (cosmetic) pesticides” that are carcinogenic or endocrine disruptive, including lindane, malathion and 2,4-D. U.S. manufacturers of 2,4-D have threatened to sue under Chapter 11 of NAFTA. It should be emphasized that such pesticide uses are being withdrawn in the U.S. because of requirements of the 1996 Food Quality Protection Act, and increasing legal liability deterrents.
NCI Ignores Evidence on Environmental Causes of Cancer
The relation of environmental factors to risks of breast cancer has been supported by a 1995 report on immigrants from high-risk nations, like the U.S. and Canada, to low-risk nations, such as Japan, and also the reverse migration (19). Slowly but surely, no matter at what age they moved from their country of origin, the immigrants assumed risks similar to those experienced by native-born women. More striking confirmation comes from a 2000 publication on a large-scale study of identical twins in Sweden, Denmark, and Finland; this showed that cancer risk in adopted children parallels that of their adoptive, rather than biological, parents. "The overwhelming contribution to the causation of cancer in the population of (90,000) twins that we studied was the environment" (20). The critical significance of these findings has been recently stressed. "Thus the conclusion from twin studies is consistent with the conclusion from migrant studies: the majority, probably the large majority, of important cancers in western populations are due to environmental rather than genetic factors. Overly enthusiastic expectations regarding genetic research for disease prevention have the potential to distort research priorities for spending and health" (21).
More striking still is the fact that the cancer establishment has ignored the June 2002 admission by Doll that most non-smoking cancers "are caused by exposure to chemicals, often environmental ones" (Appendix VII). Nevertheless, NCI and ACS policies and priorities still remain fixated on Doll's 1981 report, dismissing the role of carcinogenic environmental exposures (p. 10).
It should be further recognized that the majority of environmental and other carcinogens also induce other chronic toxic effects, notably genetic, endocrine disruptive and reproductive, neurotoxic, haematological, and immunological, for which there are no incidence trend data comparable to those for cancer. Cancer, in effect, thus likely represents a quantifiable paradigm of a wide range of other adverse public health impacts of poorly controlled or regulated industrial technologies.
Excerpted fromStop Cancer Before it Starts: How to Win the War on Cancer, 2003 by Samuel S. Epstein, M. D.
Cancer Prevention Coalition
University of Illinois at Chicago
School of Public Health
2121 W. Taylor St., MC 922
Chicago, IL 60612