U.S. Losing War on Cancer, Ignoring
February 20, 2003 (ENS) - Leading players in the war on cancer should do
more to educate the American public about how to minimize its risk of
contracting the disease, according to a new report from the Cancer
Prevention Coalition (CPC).
Americans face increasing
cancer risks from occupational and environmental exposure to industrial
carcinogens, the report finds, but established government and nonprofit
cancer organizations are fixated on treatment rather than prevention.
"This report makes it clear
that we are losing the war against cancer," said Dr. Samuel Epstein, CPC
chairman and author of "The Stop Cancer Before It Starts Campaign: How to
Win the Losing War Against Cancer." "But," he said, "there are
opportunities for reversing this trend."
Based on available data, the
overall incidence of cancers in the American population is on the rise.
Men have a little less than a one in two lifetime risk of developing
cancer, for women the risk is a bit more than one in three.
Adjusted to reflect the
aging population, the U.S. cancer incidence is up some 24 percent from
1973 to 1999. Mortality rates are up some 30 percent over the same time
But some argue these numbers
are misleading, as the medical community's ability to identify cancer has
improved over that time period. Still, cancer kills some 550,000 Americans
each year and is the second leading cause of death. Some 1.3 million
Americans contract cancer each year.
And the American war on
cancer, Epstein said, has been undermined by the myopic focus on treatment
by the National Cancer Institute (NCI), a government agency, and the
American Cancer Society (ACS), a nationwide, community based voluntary
These organizations, he
said, have been silent on a wide range of avoidable causes of cancer,
other than personal lifestyle choices such as smoking. Epstein said there
is enough evidence to warn people of the presence of industrial
pollutants, the concentrations of pesticides in nonorganic fruits and
vegetables and the possible risks of irradiated foods.
Mainstream cosmetics contain
a wide range of carcinogenic materials, he said, and there are increased
cancer risks from some prescription medications.
Epstein said neither NCI nor
ACS has taken a strong stand on the dangers from carcinogenic exposures
from pesticides or hazardous industrial waste.
"This has tacitly encouraged
powerful corporate polluters and industries to continue manufacturing
carcinogenic products," Epstein warned.
These organizations tend to
"blame the victim" for contracting cancer, he said, rather than explore
the environmental causation that could be responsible for their illness.
ACS spokesman Greg Donaldson
said Epstein's comments about his organization and its commitment to
prevention efforts are "simply false."
Identifying the specific
cause of cancer is still often extremely difficult, Donaldson said. ACS is
funding some $40 million in prevention programs, he said, including
studies into environmental causation.
"We are committed to funding
research on this," Donaldson said, "but we only speak when there is
science based evidence one way or another."
The National Cancer
Institute did not return calls for comment.
Epstein released the new
report at a press briefing today in Washington, DC and announced that the
Cancer Prevention Coalition and others will use it as a springboard for a
new grassroots effort.
This effort aims to reform
the National Cancer Institute and the American Cancer Society and to
pressure federal and state governmental organizations to improve the
public's understanding of how to limit their risks of contracting cancer.
The public should have
access to a registry compiled by NCI of "avoidable carcinogens," Epstein
said, and Congress may need to step in to ensure this happens.
What is frustrating,
according to Dr. Nicholas Ashford, a Massachusetts Institute of Technology
public policy expert, is that NCI should already be doing this.
"The legal mandate of NCI is
to inform the public about avoidable causes of cancer," he said.
This mandate comes from the
1971 National Cancer Act, signed by President Richard Nixon, and was
strengthened by amendments in 1988 that called for "an expanded and
intensified research program for the prevention of cancer caused by
occupational or environmental exposure to carcinogens."
changes to NCI under the current political climate in Washington will be
very difficult, Epstein said, but there are opportunities at state and
The Cancer Prevention
Coalition report calls on states to enact the equivalent of a toxics use
reduction act passed in 1989 by Massachusetts. The law requires statewide
industries to disclose the chemicals they use, and since its passage the
state's environmental emissions decreased by 73 percent.
"This could set the stage
for phasing out harmful carcinogens," Epstein said.
That should be the ultimate
goal, said Ashford. "When we know there are safe alternatives, we should
use them," he said. "We are not talking about bankrupting industry."
The effort to reform NCI
will closely monitor how it spends its annual budget of some $4.6 billion.
Tracking NCI's budget increases against the cancer incidence numbers,
Epstein said that "the more money we spend on cancer, the more cancer we
But he does not argue that
less money should be spent. Instead, Epstein said it should be spent
better, with much more of it earmarked for prevention efforts.
NCI should be doing more
research on avoidable exposures to industrial carcinogens, Epstein said,
and should inform the public of known risks from occupational and
environmental exposure to carcinogens.
The report suggests that
both organizations should adopt the precautionary principle and research
cancer clusters in the vicinity of major sources of urban pollution, power
plants, petrochemical factories and Superfund hazardous waste sites.
This research, Epstein said,
could complement the available data on air and water pollutants documented
through the U.S. Environmental Protection Agency's National Toxic Release
Inventory as well as data from states.
"We have not begun to win
the war on cancer," said Dr. Richard Clapp, an epidemiological professor
at the Boston University School of Public Health. "We have not even turned
"We have to move beyond the
body count and begin to prevent exposures before they occur."
To view the report, log on
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