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Environmental Cancer?

I find the President’s Cancer Panel report -at least, the general tone of it – hard to believe. Most of the headlines yesterday focused on the “grievous harm”, “bombarding”, and “grossly underestimated” statements, and suggested that there was an epidemic of environmentally-caused cancer. Since most age-adjusted cancer incidence rates have, in fact, been dropping, I find this a bit hard to believe.
Here’s the whole report (whopping PDF). Update: that link may be bad – try here. It actually does mention that cancer rate data, but (as far as I can see) just sort of blows right past it. And while I take the point that endocrine disruptors and the like need to be watched (and that we really do need to study these things more), I don’t see why the alarm bells need to be rung quite this loudly.
I see that the American Cancer Society seems to agree. My own views are closer to those of Bruce Ames (PDF) than to the President’s panel. We should always be alert to possible environmental causes of cancer, but we should also realize that (as far as we can tell) they seem to be relatively minor.

35 comments on “Environmental Cancer?”

  1. Anon says:

    This is an area where non-experts, such as Derek Lowe by his own admission, should not be commenting. His off-the-cuff opinion offer nothing of substance to this debate, and his reasonsing is non-existent and shallow.
    I also am a chemist and biochemist, and believe that environemental chemicals can and do pose large risks to human health and society’s welfare. Just look at the great number of women who have or will have breast cancer over their lifetimes, something that has been classified as an epidimic in itself, and almost certainly contributed to by environmental insults.
    Derek need so know when to keep his opinions to himself. This is one area he should do just that.

  2. qetzal says:

    Yeah, Derek! You’ve got no right to offer non-expert, off-the-cuff opinions on this stuff!
    In contrast, it’s perfectly acceptable for anonymous blog commenters to offer their own non-expert, off-the-cuff opinions, right Anon?

  3. Hap says:

    I’m sorry, but apparently I’ve had too much sleep to understand your comment. Are you saying that because his opinion disagrees with yours [excuse me, because it’s devoid of reasoning (snicker)], he should discuss them on his own blog? Because if so, you’ve been either hanging out with Karl Rove too much or need to have the air quality in your home checked.
    As a side note, wouldn’t a respectable opinion on someone else’s reasoning skills require some of one’s own (and testimony to that effect)? Just saying.

  4. nitrosonium says:

    It is epidemic. not epidimic. Furthermore “need so know” should be “needs to know”.
    You should keep your misspellings and poor grammar to yourself. This is one area you should do just that.

  5. Hap says:

    I’m sorry, but apparently I’ve had too much sleep to understand your comment. Are you saying that because his opinion disagrees with yours [excuse me, because it’s devoid of reasoning (snicker)], he should discuss them on his own blog? Because if so, you’ve been either hanging out with Karl Rove too much or need to have the air quality in your home checked.
    As a side note, wouldn’t a respectable opinion on someone else’s reasoning skills require some of one’s own (and testimony to that effect)? Just saying.

  6. Anonymous says:

    I’m much more interested in Derek’s opinion on the matter than Anon #1’s, primarily because his opinions include links to the literature where I can read directly what the experts have to say on the matter. Those experts (the American Cancer Society and a Molecular Biol. team out Berkeley and LBL) appear to be more concerned about having a disproportionately large focus on environmental causes of cancer rather than a disproportionally small one. Anyone have any authoritative links for the opposite opinion?

  7. partial agonist says:

    Derek, thanks for your opinion and thanks for the link to the Ames paper.
    Anon #1, did you read the Bruce Ames pdf, or is Dr. Ames also unqualified to comment? Should we assume that Anon #1 and Jimmy Carter have devoted many decades to cancer research and together have >500 publications in the field, like Dr. Ames?
    Pray tell, Mr. Anon #1, what is it that you bring to the table that lets me trust your anonymous assurances over the evidence cited by Dr. Ames?

  8. startup says:

    #2-7. Your insults are environmental!

  9. Curt F. says:

    Thanks very much to Derek for the link to the Ames paper.
    First, it’s obviously notable anytime the American Cancer Society feels compelled say that a new report about the dangers of cancer may be overstated.
    Second, the Ames paper is amazingly on-point in rebutting the PCP report even though it was written 8 years ago. “Misconception #2: Environmental synthetic chemicals are an important cause of human cancer.”… “Misconception #4: Human exposures to carcinogens and other potential hazards are primarily to synthetic chemicals.” .
    Third, one possible small reason for the discrepancy in the two sources (the Ames .pdf and the PCP report) is different ways of looking at hormonally-related cancers. The Ames paper says that environmental contamination with synthetic chemicals are not as important as hormonal imbalances in causing cancer. The PCP report says that some synthetic chemicals contaminating the environment cause hormonal imbalances. Thus the PCP seems to be saying that synthetic chemicals can contribute to some cancers by interfering with normal hormonal processes. Thus some cancers that Ames et al. does not treat as environmentally related may in fact be justifiably attributed to environmental factors. But I am no expert here. This is just one possibility that came to mind as I skimmed to two documents.
    Third, I wonder how the Presidential Cancer Panelists feel about the American Cancer Society’s response to their report. Can anyone point me to public commentary by members of the Presidential Cancer Panel about reaction to the report?

  10. phred says:

    The American Cancer Society is a tool of industry and anything they say should be taken with a grain of salt.

  11. Sili says:

    nything they say should be taken with a grain of salt.

    Shouldn’t you first make sure that salt doesn’t cause cancer?

  12. dearieme says:

    It’s interesting to see what different countries tend to agonise about in (presumably) irrational ways. With the US it’s cancer. Cancer rates, corrected for age, have been declining for decades but still the US has a fetish about cancer, a War on Cancer, a Presidential Panel on Cancer, and the like. I wonder whether the French obsession about their bowels might be a cheaper addiction to feed.

  13. dearieme says:

    By the way, about that Ames paper: he offers the standard line, as of 2002, on the effect of eating fruit and vegetables on cancer risks. That’s now in some doubt, apparently.

  14. Boo says:

    It’s those darned Republicans — always politicizing science! The Bush administration should be ashamed at itself for denying the truth!
    Oh, wait…never mind.

  15. smurf says:

    Smoking, alcohol, weight – three key factors that contribute to almost ALL cancers.
    Stop smoking, reduce the intake of alcohol, go to the gym, and lose weight.
    Makes you even sexy!

  16. JOhn says:

    In an effort to better understand the relationship between environmental exposures and cancer, my colleagues and I just completed the most extensive review of death certificates and life histories that has ever been conducted in the US. We traveled to local government records offices in over 250 municipalities in all 50 states to review 10,342 death certificates of individuals who died of cancer between 1879 to 2010.
    One of the most remarkable findings of our study was that within this study population, multiple death certificates had been filed for only 234 individuals, indicating a >99% (p = 0.001) protective effect against cancer of having died previously from some other cause. Thus the widespread adoption of childhood vaccinations, the widespread use of antibiotics and anti-hypertensive drugs, and the wholesale chlorination of our water supply are revealed as having undermined the anticancer protective effects of natural processes such as diptheria, smallpox, tuberculosis, bacterial infections, cholera, and heart disease.
    Indeed, the insidious and relentless increase in life expectancy in this country (7 years since 1960) has regrettably and unnecessarily enhanced our exposure to old age, the most important risk factor for developing this awful disease.
    Remarkably, the small population who died of cancer subsequently to having died of some other cause were united in being identified on their death certificate by name only, without a social security number. A majority of these people were named Smith or Jones, suggesting the presence of some shared familial trait. We are currently working to investigate the nature of this genetic factor as well as the mechanism by which registering with the Social Security Agency eliminates the anticancer protective effect of having died previously.

  17. Mark says:

    On a long enough timeline, the survival rate for everyone drops to zero.

  18. Anonymous says:

    The one interesting recommendation in the report that there should be some general consensus over is “For those whose jobs may expose them to chemicals, remove shoes when entering the house and wash work clothes separately from the rest of the laundry.”

  19. Arthur Dent says:

    “For those whose jobs may expose them to chemicals”
    Hard to think of any job where you are not exposed to chemicals. Wasn’t it a pity that the good lord didn’t read the environmentalists handbook before constructing this big wide world of ours out of those nasty chemicals.

  20. Ronathan richardson says:

    I really don’t get why we wouldn’t err on the side of safety here. We’re spraying methyl iodide on crops in California now–if I were to design a carcinogen, that’d probably be one of the first scaffolds I’d choose. I guess my point is that, well, 1) we know that “chemicals” (I try to tell public health crusaders that scientists laugh when you say that word) can definitively cause cancer, through cigarette smoke, radon, burnt meat, asbestos, nickel compounds, etc; 2) Most human blood samples contain questionable amounts of mutagens, endocrine disruptors, and most importantly, many compounds of which the biological effects are totally unknown; 3) There’s reasonable evidence to include that some carcinogen-exposed occupations and regions have higher rates of cancer. Would it be expensive to regulate all the compounds in products–yes. But for the, say, 1,000 compounds we’re exposed to most, plus every new compound on the market, at least an Ames test and exposing/1 year monitoring of ~30 mice–probably feasible at $100,000 per compound if done with any throughput–and then finding less-carcinogenic replacements for the bad ones–we’d have a much better idea of what we’re dealing with. It’d be hard, and expensive, and even if it only reduced cancer rates by 5% by getting a few bad eggs off the market, that’d be 20,000 lives saved a year, and probably $2 billion in healthcare spending saved. That’s all.

  21. John says:

    The numbers I have seen and which are quoted in part in the ACS report on this subject ( suggest that only single digit percentages of cancer in Americans are caused by occupational exposures, and that the overwhelming majority of these are due to asbestos. The most important exogenous carcinogen exposures faced by most Americans appear to be cigarette smoke and dietary fat, probably followed by heterocyclic amines formed in cooked meat.
    This makes sense if you think about it. First, the environment has already been cleaned up to a remarkable extent since the 1960’s (when I was a kid you used to read about urban waterways catching fire), and there has been no corresponding substantial dropoff in cancer rates. Second, only a minority of cancer patients treated with multiple cycles of near-fatal doses of DNA damaging agents develop secondary cancers. Third, even lifelong smokers, who deliberately concentrate and inhale high concentrations of known carcinogens 15 or more times a day have an 83% chance of NOT dying of lung cancer.

  22. Sili says:

    I find the President’s Cancer Panel report -at least, the general tone of it – hard to believe.

    Well. revere doesn’t.

    It is strong stuff, but it is also stuff experts in cancer epidemiology have known for a long time.

    I have yet to read Orac in full, but he does seem a tad more cautious, if you prefer that.

    From my perspective, the report is a mixed bag, mostly good but not all.

  23. sepisp says:

    #20 or Ronathan richardson has reinvented REACH. Gongcratulations! (Except that REACH conformance tests have a cost in the order of millions, not hundreds of thousands.)
    Needles to say, USA and Japan weren’t particularly happy with the idea.

  24. john says:

    Anyone know what the cancer rates are in chemists vs. normal population. I’ve always wondered this as we actually are in a position to have chance exposures to numerous chemicals.
    Of course when you look at the Ames paper oxidative stress/chronic inflammation are a significant cause, and it’s not like the average bench chemist working the hours we do under the expectations we do aren’t in a state of stress which cause these conditions.

  25. Vader says:

    “nyone know what the cancer rates are in chemists vs. normal population.”
    Not sure what to make of the idea of chemists being part of the abnormal population.
    But I believe a study was done at Los Alamos on local cancer rates, due to a scare from a cluster of brain tumors. The conclusion was that this population of people, who presumably had an unusually high occupational exposure to potential carcinogens, had an overall lower cancer rate than the general population. The brain tumor cluster was just that, a random statistical fluctuation.

  26. Vader says:

    Oh, and:
    I find the President’s Cancer Panel report -at least, the general tone of it – hard to believe.
    I don’t find it hard to believe. Just hard to take seriously.

  27. David L. says:

    It’s a surprise that idiot politicians don’t understand science but use any “science” they have to push political agendas?

  28. Hello friends –
    As noted by Sili, David Gorski has another interesting take on this paper at science based medicine today.
    One thing that seems to be in conflict here is the idea of a strict decline in cancer rates. According to Gorski (and, presumably, the paper), rates of childhood cancers are rising in manners that are not possible to explain via genetics and/or improved diagnostics. He gives a lot of attention towards the difference between adult exposure to chemicals and developmental exposure.
    I’d also note that anytime the ACSH comes out against policy recommendations, I know someone has made a sensible argument that likely will affect health for the better.
    – pD

  29. lugan11 says:

    Benzene: so carcinogenic it is practially banned from laboratories.
    But it makes up a significant (and volatile) fraction of gasoline.
    But no one in the US thinks twice about exposure to this carcinogen when they fill their gas tank once-twice weekly. Even pregnant women are not worried.
    Since Americans began filling their own gas tanks in the ’80’s, has no one tried to do epidemiologic studies to see if that exposure can be hazardous?

  30. lynn says:

    @29 You’ve got 2 control states, as New Jersey and Oregon have banned self-pumping since 1949 and 1951 respectively.

  31. Cloud says:

    @28- I don’t think Dr. Gorski addressed whether or not the decline in childhood mortality from other causes (e.g., infectious diseases) could account for the increase in cancer diagnoses.
    That is one possible explanation.
    I suspect it will turn out to be a combination of factors- some increased risk due to crap in the environment, some apparent increased risk due to not dying of pertussis, etc. But that is just my only marginally educated guess.

  32. John says:

    #24, the Royal Society of Chemistry did a study of cancer in chemists in the 1970’s, and found moderately elevated rates of leukemia and pancreatic cancer. The overall level of cancer was lower and life expectancy was higher than in the general population, which was explained as being part of the well known phenomenon of cancer rates being lower in more educated and affluent populations.
    While the study included people who were not organic chemists and even some managers, this is probably more than offset by the abysmal chemical hygiene practices of the era. I think a lot of labs did not even have fume hoods until the mid to late 1960s.

  33. Phil says:

    #29 “Benzene: so carcinogenic it is practially banned from laboratories.”
    Stay away from my lab, I have a 250 mL bottle sitting in my hood.
    This addresses an issue that was brought up earlier: chemists may very well NOT have any higher risk of cancer due to chemical exposure because we are trained in the use of personal protective equipment. Migrant farm workers who practically bathe in pesticides aren’t as lucky.
    It’s not scientists who are trained to work with hazardous chemicals who are in the most danger, it’s the blue collar workers in factories or auto shops or wherever chemicals are used without strict safety policy.
    I still have to side with Derek in my gut reaction to this study. Overall, chemical exposure seems not to be a worry for the average individual.

  34. Morten G says:

    Since when does this blog treat cancer as one disease?
    There was a lot more environmental pollution 50 years ago so if the overall cancer rates have declined since then doesn’t that indicate a connection between overall cancer rates and environmental factors?
    If we break it down to individual cancers, testicular cancer rates more than doubled during the 25 year period from 1977 to 2002 in South Australia. You get testicular cancer usually between 15 and 40 years old so age is not a risk factor.
    Anon is a coward but he’s right when he says that you guys need a kick in the nuts.

  35. Derek Urion says:

    You can certainly see your skills within the paintings you write. The sector hopes for even more passionate writers such as you who are not afraid to mention how they believe. All the time go after your heart. “The only way most people recognize their limits is by trespassing on them.” by Tom Morris.

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