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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 from
Stop
Cancer Before it Starts: How to Win the War on Cancer,
2003 by Samuel S. Epstein, M. D.
CONTACT:
Cancer Prevention Coalition
University of Illinois at Chicago
School of Public Health
2121 W. Taylor St., MC 922
Chicago, IL 60612
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