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- Indifference and hostility to prevention
- Conflicts of interest
The
American Cancer Society (ACS) has not only remained silent about
known carcinogens from our midst, it has lent its considerable influence
and media muscle to help industry trivialize such risks. Thumbing
its nose at an impressive body of legislative and regulatory precedents
such as the Delaney amendment, which until 1996 banned the addition
of known carcinogens to food products, the ACS has consistently
rejected the relevance of animal evidence as predictive of human
risk. (In direct contradiction to previous ACS protests and statements,
Eyre claims the Society had not supported Delaney because it "was
just not strong or potentially effective enough.") When studies
unequivocally proved in 1971 that diethylstilbestrol (DES) caused
vaginal cancers in teenage daughters of women who had taken the
drug during pregnancy, the ACS refused to testify at congressional
hearings on whether the FDA should ban the drug's use as an animal-feed
additive. (It had long ignored evidence that DES is a potent carcinogen
in rodents, known since 1939.) And in 1977, the ACS called for a
congressional moratorium on the FDA's proposed ban on saccharin,
going so far as to advocate its use by nursing mothers and babies
in "moderation" despite clear-cut evidence of its carcinogenicity
in rodents and very suggestive evidence of bladder cancer in humans.
Backing the cosmetics industry in 1977
and 1978, the ACS fought proposed regulations for permanent dark
hair-coloring products containing
dyes known to cause breast cancer in animals, and now implicated
as a cause of non-Hodgkin's lymphoma and other cancers. In 1982
it formally codified its insistence on unequivocal human evidence
of
carcinogenicity before speaking out against potential public health
hazards, ignoring virtually every tenet of responsible public health
policy. The Society, however, apparently has no problem defending
chemicals or products when no such proof of their safety exists.
In 1992, the ACS issued a joint statement with the Chlorine Institute
in support of the continued global use of organochlorine pesticides,
despite evidence that some were known to cause breast and other
cancers. And in 1996, it joined a diverse group of patients and
physician
groups to file a petition against the FDA to ease restrictions
on silicone breast implants. The ACS failed to disclose industry
studies
that showed the gel in the implants induced cancer, and that the
implants were contaminated with known carcinogens such as ethylene
oxide and crystalline silica.
In its latest annual report, Cancer Facts & Figures 2002,
the 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." Despite a promise of "cancer
facts," the ACS neglects to inform the public about a number
of well-documented cancer risks. Among them: dusting the genital
area with talc increases risk of ovarian cancer; home and garden
use of pesticides, consumption of nitrite-preserved hot dogs contaminated
with the highly potent carcinogen nitrosamine are well-recognized
risk factors for childhood leukemia and brain cancer; and animal
and dairy fats and mainstream produce are exposing consumers to
a wide range of carcinogenic pesticide residues, unlike safer organic
foods.
History
of ACS Indifference and Even Hostility to Prevention
- In 1971, when studies
unequivocally proved that diethylstilbestrol (DES) caused vaginal
cancers in
teenaged daughters of women administered
the drug during pregnancy, the ACS refused an invitation to testify
at Congressional hearings requiring the FDA to ban its use as a growth
promoting hormone for cattle in feedlots.
- In 1977 and 1978, the ACS opposed regulations proposed
for black or dark brown hair coloring products, containing coal
tar dyes
known to cause breast and liver cancer in rodents, in spite of evidence
of human risk.
- In 1977, the ACS called for a Congressional
moratorium on the FDA’s
proposed ban on saccharin, and even advocated its use by nursing
mothers and babies in "moderation," despite clear-cut
evidence of its carcinogenicity in rodents.
- In
1978, Tony Mazzocchi, then senior representative of the Oil,
Chemical and Atomic Workers International Union, stated at a
Washington, D.C.
roundtable between public interest groups and high-ranking ACS
officials: "Occupational
safety standards have received no support from the ACS."
-
In 1978, Congressman Paul Rogers censured the ACS for doing "too
little, too late" in failing to support the Clean Air Act.
- In 1982, the ACS adopted a highly restrictive
cancer policy that insisted on unequivocal epidemiological evidence
of carcinogenicity
before taking any position on public health hazards. Accordingly,
the ACS still trivializes or rejects evidence of carcinogenicity
in experimental animals, and has actively campaigned against
laws (the 1958 Delaney Law, for instance) that ban deliberate addition
to food of any amount of any additive shown to cause cancer in
either animals or humans.
- In 1984, the ACS created the October
National Breast Cancer Awareness Month, funded and promoted by
Zeneca, an offshoot of the U.K.
Imperial Chemical Industry, a major manufacturer of petrochemical
products.
The ACS leads women to believe that mammography is their best
hope against breast cancer. A recent ACS advertisement promised
that "early
detection results in a cure nearly 100% of the time." Responding
to questions from a journalist, an ACS communications director
admitted: "The
ad is based on a study. When you make an advertisement, you just
say what you can to get women in the door. You exaggerate a
point. Mammography today is a lucrative [and] highly
competitive business." Even more seriously, the Awareness Month publications
and advertisements studiously avoid any reference to the wealth
of information on avoidable causes and prevention of breast cancer.
-
In 1992, the ACS supported a statement by the Chlorine Institute
defending the continued global use of organochlorine pesticides—despite
clear evidence of their persistence and carcinogenicity. Society
Vice President Clark Heath, M.D., dismissed evidence of this risk
as "preliminary and mostly based on weak and indirect associations."
-
In 1992, the ACS launched the breast cancer "chemoprevention" program,
in conjunction with the NCI, aimed at recruiting 16,000 healthy
women at supposedly "high risk," into a 5-year clinical
trial with the highly profitable drug Tamoxifen, manufactured
by Zeneca.
Evidence of the claimed effectiveness of Tamoxifen is, at best,
arguable. Furthermore, evidence of the drug's life-threatening
adverse effects
in healthy women is trivialized. More seriously, information
that Tamoxifen poses grave risks of liver cancer, as it is a
highly
potent liver carcinogen in rats in whom it also induces irreversible
DNA
adducts, remains undisclosed to women recruited into clinical
trials.
- In 1992, The Chronicle of Philanthropy, the
nation’s leading charity watchdog, warned that the ACS was
“more interested in accumulating wealth than in saving lives.”
- In
1993, just before PBS aired the Frontline special entitled, "In
Our Children’s Food," the ACS came out in support
of the pesticide industry. In a damage-control memorandum, sent
to some
48 regional divisions and their 3,000 local offices, the ACS
trivialized pesticides as a cause of childhood cancer. ACS also
reassured the
public that food contaminated with residues of carcinogenic pesticides
is safe, even for babies. When the media and concerned citizens
called ACS, they then received reassurances crafted by Porter-Novelli,
a
powerful PR firm for the agribusiness industry and then rehashed
and sent to another client, the ACS: "The primary health
hazards of pesticides are from direct contact with the chemicals
at potentially
high doses, for example, farm workers who apply the chemicals
and work in the fields after the pesticides have been applied,
and people
living near aerially sprayed fields. The American Cancer Society
believes that the benefits of a balanced diet rich in fruits
and vegetables far outweigh the largely theoretical risks posed
by occasional,
very low pesticide residue levels in foods." In support
of this ACS-agribusiness initiative, these reassurances were
then rehashed
for a third time by the right-wing group, Accuracy in Media (AIM),
which published quotes from the ACS memorandum in an article
with the banner headline: “Junk Science on PBS,” with
an opening, “Can
we afford the Public Broadcasting Services?”
- In
February 1994, the ACS published a study designed to reassure
women on the safety of dark permanent hair dyes and trivialize
risks of fatal and non-fatal cancers, as documented in over six
prior reports.
However, the ACS study was based on a group of some 1,100 women
with an initial age of 56 who were followed for seven years only.
The
ACS concluded that "women using permanent hair dyes are
not generally at increased risk of fatal cancer." However,
risks of cancer in women over 63 are up to 20 times higher for
non-Hodgkin's
lymphoma and multiple myeloma, 34 times for bladder cancer, and
8 times for breast cancer. As designed, the ACS study would have
missed
the great majority of these cancers, and excluded dark hair dyes
as important risks of avoidable cancers.
- In September
1996, the ACS together with patient and physician organizations,
filed a "citizen’s petition" to pressure FDA
to ease restrictions on access to silicone gel breast implants.
What
the
ACS did not disclose was that the gel in these implants had clearly
been shown to induce cancer in several industry rodent studies,
and that these implants were also contaminated with other potent
carcinogens,
notably ethylene oxide and crystalline silica.
- In 1998, ACS allocated $330,000, under 0.1% of its $678 million
revenues, to research on Environmental Carcinogenesis, while
claiming allocations
of $2.6 million, 0.4% of its revenues. Furthermore, in its annual
publication, Cancer Facts & Figures, designed to provide
the public and medical profession with "basic facts" on
cancer, other than information on incidence, mortality and treatment,
there
was little or no mention of primary prevention. For breast cancer,
ACS stated: "Since women may not be able to alter their
personal risks factors, the best opportunity for reducing mortality
is through
early detection."
- In May 1999, the ACS issued a statement
trivializing cancer risks from consumption of genetically engineered,
rBGH/BST, milk containing
high levels of the growth factor IGF-1. This reassurance was
in striking contrast to substantial published scientific evidence that elevation
in blood levels of IGF-1 are strongly associated with excess
risks
of breast, colon and prostate cancers.
- In the
January 21, 2000, Cancer Letter, commenting on the ACS behind
the scenes creation of a Legislative Committee to gain
major control
of national cancer policy, Dr. John Durant, former executive
President of the American Society of Clinical Oncologists, charged: “It
has always seemed to me that was an issue of control by the ACS
over the cancer agenda. They are protecting their own fundraising
capacity
. . .” from competition by survivor groups.
- In the January 28, 2000, Cancer Letter, it was revealed that
the ACS had close ties to the tobacco industry. Shandwick International,
representing R.J. Reynolds Holdings, and Edelman, representing
Brown & Williamson
Tobacco Company, have been major PR firms for the ACS in its
attempts to rewrite the 1971 National Cancer Act, and in conducting
voter
education programs in the past presidential campaign.
- In the ACS Cancer Facts and Figures 2002, the Community Cancer
Control Section includes a “Look Good … Feel Better
program to teach women cancer patients beauty techniques to help
restore their
appearance and self-image during chemotherapy and radiation treatment.” This
program is partnered by the National Cosmetology Association
and The Cosmetic, Toiletry and Fragrance Association Foundation,
which
have failed to disclose the wide range of carcinogenic ingredients
in toiletries and cosmetics. These trade organizations have also
failed to disclose evidence of excess risks of breast and other
cancers following long-term use of black or dark brown permanent
and semi-permanent
hair dyes. The ACS has failed to inform women of these avoidable
risks.
- In the ACS Cancer Facts and Figures 2002,
the Environmental Cancer Risk Section dismissively reassures
that carcinogenic exposures
from dietary pesticides, "toxic wastes in dump sites," ionizing
radiation from "closely controlled" nuclear power plants,
and non-ionizing radiation, are all "at such low levels
that risks are negligible."
The ACS
track record on primary prevention is likely to be perpetuated in
future policies of the NCI following the February 2002 appointment
of Dr. Andrew Von Eschenbach as NCI Director; prior to this, Von
Eschenbach was President-Elect of the ACS. Furthermore, as a condition
of appointment as NCI Director, Von Eschenbach continued his leadership
of the National Dialogue on Cancer.
Excerpted from “The
High Stakes of Cancer Prevention” by Samuel Epstein
and Liza Gross, Tikkun Magazine, Nov/Dec 2000
www.tikkun.org
For more
detailed and updated information, see
The
Stop Cancer Before It Starts Campaign: How to Win the Losing War
Against Cancer, 2003
CONTACT:
Samuel S. Epstein, M.D., Chairman
Cancer Prevention Coalition
2121 W. Taylor St., M/C 922
Chicago, IL 60612
e-mail epstein@uic.edu
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