Chicago Tribune

Date: Tuesday, June 17, 2003

Edition: Chicago Final

Section: Commentary Page: 17 Zone: C

Source: By Samuel S. Epstein and Quentin D. Young. Dr. Samuel S. Epstein is

chairman of the Cancer Prevention Coalition and professor emeritus of

environmental and occupational medicine at the University of Illinois at

Chicago School of Public Health. Dr. Quentin D. Young is chairman of the

Chicago-based Health and Medicine Policy Research Group and a director of

the Cancer Prevention Coalition.

Illustration: GRAPHIC

The sad truth about the stark rise in childhood cancer

When it comes to the safety of children, Americans are among the most

cautious parents in the world. We strap our kids into helmets and kneepads

before letting them coast down the block on their bikes. We cover electrical

outlets with plastic caps and make sure vehicle safety seats are securely

installed, backward-facing until our babies toddle past their first

birthdays. When they venture off to school, we teach our children not to

speak to strangers, about "bad touches" and how to dial 911.

Yet when it comes to preventing the disease most likely to kill children, we

seem to be at a loss. Childhood cancer now strikes about 9,000 kids under

the age of 15 yearly, with about 1,500 deaths.

What's more, children are more likely than adults to have developed advanced

cancer by the time they are diagnosed. A startling 80 percent show signs at

diagnosis that the disease has spread elsewhere in the body. Just how old

are these children when diagnosed with cancer? The median age is 6.

Making matters worse, the number of children diagnosed with cancer each year

has been rising dramatically. From 1975 to 2000, childhood cancers increased

by 32 percent--36 percent in African-Americans--making cancer the biggest

health threat to our children, second only to accidents in its lethal

impact. Specifically, acute childhood lymphocytic leukemia is up 57 percent;

brain cancer, 50 percent; kidney cancer, 48 percent; and bone cancer, 29

percent.

Sadly, many of these cancers could have been avoided. But parents remain

uninformed about the wide range of carcinogenic exposures that pervade the

landscape of our children's lives, seeping into their bodies through

contaminated drinking water, chemically preserved wooden playground sets,

pediatric prescription drugs--even the flea collar around Fido's neck.

Making matters worse, parents have been kept in the dark about their own

ability to help protect children from these dangerous exposures.

Why? Because the federal National Cancer Institute and the non-profit

American Cancer Society have never warned the public about the numerous

consumer products and other common exposures that can cause cancer in

children, and also lead to cancer in later life. They have also failed to

warn the public that the incidence of childhood cancer has been rising

steadily for more than two decades.

The public has an undeniable right to know that there is strong reputable

science that links childhood cancers to exposures of the fetus, infants and

children. These avoidable exposures fall into four main categories:

environmental (e.g., pesticides in drinking water and baby food and from

urban and school spraying of pesticides); occupational (e.g. maternal

exposure during pregnancy to carcinogens in the workplace); domestic and

household (e.g., nitrite-preserved hot dogs, pesticide use in the home and

lawn and shampoos and lotions with carcinogenic ingredients); and medical

(e.g., Ritalin, commonly prescribed for attention deficit disorders).

Notwithstanding substantial contrary evidence, the ACS dismisses cancer

risks from exposure to dietary pesticides, hazardous waste sites, and

radiation from nuclear power plants as "negligible." The ACS 2003 "Cancer

Facts & Figures," in its section on childhood cancer, makes no reference at

all to any causes.

The NCI takes the same head-in-the-sand approach. "The causes of childhood

cancer are largely unknown," the federal organization flatly asserts. Never

mind that this simply isn't so.

The failure of the NCI and ACS to inform the nation of the risks from

carcinogenic exposures has also resulted in a failure to regulate such

exposures. For example, the Environmental Protection Agency's Scientific

Advisory Board is now developing new guidelines for regulating risks from

"early-life exposure to carcinogens."However, the EPA is only considering

isolated risks of individual carcinogens in air and water, rather than

assessing their multiple and cumulative impact, besides numerous unrelated

exposures to carcinogens under the jurisdiction of the Food and Drug

Administration and other regulatory agencies.

Because of their smaller size, lower body weight, and faster metabolism,

children, infants, and, even more so, the fetus, are far more vulnerable to

carcinogenic and toxic exposures than adults--a fact recognized by President

Bush during his candidacy but apparently forgotten once he took office. At

that point, federal spending for children's health programs at the EPA fell

by a solid--and shameful--10 percent.

The lack of research and public information stems not from a lack of

resources, but from imbalanced national policies. Since passage of the 1971

National Cancer Act, which called on NCI to undertake research and provide

the public with information on the causes and prevention of cancer, its

annual budget has escalated to $4.6 billion from $220 million. While NCI's

budget was growing, so, paradoxically, was the incidence of childhood

cancer, along with non-smoking related adult cancers. Yet NCI spends less

than 4 percent of its $4.6 billion budget for research and public

information on avoidable causes of cancer, while the ACS spends less than 1

percent of its $800 million from public support (excluding income from

government grants and investments from $1 billion reserves) on environmental

and other causes. The overwhelming majority of NCI and ACS funds are

dedicated to screening, diagnosis and treatment of cancer--obviously worthy

pursuits, but ones that would become much less crucial were they to devote

more equitable resources to prevention and public education.

Parents cannot protect their children from threats they know little or

nothing about. Clearly, the time for open public debate and congressional

oversight of national cancer policy is long over-due.