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Memo to the American Cancer Society: Every Cancer Counts

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A recent dust-up between the American Cancer Society (ACS) and the President's NIH Cancer Panel may have left the public even more confused about how dangerous untested, potentially toxic consumer chemicals and environmental pollutants really are.

The President's Panel (in this case, appointed not by Obama but by Bush) warned in a report last week that  "the true burden of environmentally induced cancers has been grossly underestimated." While conceding that environmental carcinogens "do not represent a new front in the ongoing war on cancer" the panel nonetheless concluded that "the grievous harm from this group of carcinogens has not been addressed adequately by the National Cancer Program. The American people -- even before they are born -- are bombarded continually with myriad combinations of these dangerous exposures."

What was the response from the American Cancer Society?

Well, at first blush, it seemed like they agreed. The ACS posted a comment by Michael J. Thun, MD, referring to the Cancer Society's own studies on environmental causes of cancer, and saying:

"Issues highlighted in both reports include the accumulation of certain synthetic chemicals in humans and in the food chain; the large number of industrial chemicals that have not been adequately tested; the potentially greater susceptibility of children; the possibility that some chemicals or combinations of chemicals may have effects at low doses; and the potential risks from widely used medical imaging procedures that involve ionizing radiation."

So far, so good. But then Dr. Thun lashed out:

"The perspective of the report is unbalanced by its implication that pollution is the major cause of cancer ... its conclusion that 'the true burden of environmentally (i.e. pollution) induced cancer has been grossly underestimated' does not represent scientific consensus."

The ACS comment was widely and understandably reported as an attack on the scientific validity of the Cancer Panel's findings. But in reality, the Cancer Panel never said that pollution is the major cause of cancer. Here's its conclusion on that topic:

"At this time, we do not know how much environmental exposures influence cancer risk and related immune and endocrine dysfunction."

The ACS also attacked the Cancer Panel for "its dismissal of cancer prevention efforts aimed at the major known causes of cancer (tobacco, obesity, alcohol, infections, hormones, sunlight)...."

Again, the Panel did not dismiss such efforts -- indeed it focused heavily on sun exposure as one of the environmental causes of cancer that concerned it. And its section on radon exposure and lung cancer emphasized the evidence that it is the combination of radon exposure and smoking -- not radon alone -- that creates the greatest risk.

So why, given the substantial agreement and overlap in approach, did the ACS react so strongly and go on to misrepresent the findings of the Cancer Panel as if the NIH were an antagonist, rather than an ally?

Well the ACS has long been criticized for overemphasizing cancer screening and treatment instead of prevention, and it has long insisted that only a small percentage of cancers have environmental or chemical causes, even as it concedes that we really have almost no data on how many cancers are caused by such chemical exposures.

The ACS has also been criticized for being influenced by members of its board who have financial interests in funding for screening and treatment -- but not prevention. Indeed, The Chronicle of Philanthropy famously once blasted the ACS as being "more interested in accumulating wealth than saving lives."

Whatever the motivation, it's clear that the ACS believes it's easier to change individual behavior (diet, exercise, smoking) than it is to regulate chemical exposures. In all of its literature, the ACS puts a priority on "modifiable risk factors" -- but leaves improved regulation of industrial chemicals out of that basket of options.

For example, in a final, sad comment on the President's NIH Cancer Panel, the ACS stated that "it would be unfortunate if the effect of this report were to trivialize the importance of other modifiable risk factors that, at present, offer the greatest opportunity in preventing cancer."

Apparently, testing and limiting human exposure to chemicals that might cause cancer simply is not a great opportunity "at present" because -- according to the ACS -- such chemical exposure isn't "modifiable."

No wonder we don't know enough about how much we're at risk from the thousands of untested chemicals that we're exposed to. The major nonprofit voice on cancer simply doesn't think it's important that we find out.

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