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#385 - Cancer Dangers Increasing Sharply, 13-Apr-1994

A white male of the baby boom generation is about twice as likely to
get cancer as his grandfather was, and a white female of the same age
has about a 50% greater chance of getting cancer than her grandmother
did, according to a study published in February in the JOURNAL OF THE
AMERICAN MEDICAL ASSOCIATION (JAMA).[1]

The new JAMA study is limited to white people. The historical data
(1950-1989) we show in Table 1, below, are also limited to whites
because data on non-whites from the 1950s and 1960s are considered
unreliable. (Racial bias in the medical research community appears to
explain the poor quality of historical cancer data for non-whites:
until the 1970s, either the data were not collected at all or the data
were not collected systematically enough to allow comparison with data
for whites.)

The new JAMA study confirms for whites in the U.S. what previous
studies had shown for many industrialized countries: that the incidence
(occurrence) rate for many cancers is increasing steadily even though
the death rate for some cancers has been falling.[2] Incidence rates
and death rates are calculated per 100,000 persons in the population,
and they are standardized to the age of the population in a selected
year (1970 is often the year selected) so that the data can be reliably
compared from one year to the next despite changes in the ages of the
population. This means that the rising rates reported in JAMA and
elsewhere are NOT caused by the population simply growing older.

As Table 1, from the National Cancer Institute, shows, there are two
cancers (stomach and cervix) for which both incidence and deaths are
diminishing as time passes.[3] These are the only really good news.

There are 8 cancers for which the death rate is diminishing even as the
incidence rate is rising: colon/rectum, ovaries, larynx, testicles,
bladder, lymph [Hodgkin's], childhood cancers, and leukemias [cancers
of the blood-forming organs]. These 8 are the cancers that people are
"learning to live with" through advances in surgery, chemotherapy and
radiation therapy. Survivors are often disfigured and debilitated by
life-saving treatments. (See RHWN #222.)

There are six cancers for which both the incidence rates and the death
rates are rising: lung, skin, female breast, prostate, kidney, and non-
Hodgkin's lymphomas. Many of these are major killers, as Table 1 shows.
These six are unmitigated bad news.

It is common to "explain away" rising cancer rates by observing that
the biggest increase is in lung cancer, and then to write off these
deaths as inconsequential because many of them they are caused by
tobacco, and are therefore, in some sense, self-inflicted. This view
ignores compelling evidence that tobacco is as addictive as heroin and
morphine,[4] and that tobacco corporations spend billions each year to
get people hooked and keep them that way. This view also avoids asking:
what is it about life in America that impels so many citizens to
inflict an early, painful death upon themselves and upon those they
live with?

The new JAMA study distinguishes cancers related to smoking (lung,
mouth, larynx, and pharynx) and shows that non-tobacco-related cancers
are also rising among Americans.[5] A white male born in the 1940s has
twice the chance of getting a non-tobacco-related cancer, compared to
his grandfather. Among women born in the 1940s, the chance of a non-
tobacco-related cancer is 30% higher, compared to their grandmothers'
chances.

The JAMA study concludes that cancer-causing hazards besides smoking
have been introduced into the U.S. population in the past several
decades, and into other industrialized countries as well. Better
diagnosis explains some but not all of the increase, JAMA says, because
the rise in cancers started before improved diagnostics became
available.

Sweden has been maintaining proper cancer statistics longer than any
other country in the world, and a recent study of Swedish people shows
cancers rising among younger populations there,[6] just as in the U.S.
This is important bad news. The recently-introduced causes of cancer in
Sweden and the U.S. remain largely unidentified. Medical and industrial
sources of radiation are certainly implicated, though often ignored;
the JAMA study does not mention radiation.[7] The JAMA study suggests
that something useful might be learned by studying farmers. Farmers
smoke less and are more active than most people. They are also exposed
to more engine exhausts, chemical solvents, pesticides, fuels, animal
viruses, and sunlight than most people. Could these exposures be why
farmers get more cancers than other people? (See RHWN #375.)

After 20 years of fruitless searching for a "cure" for cancer, the
search now seems to be veering, slowly, toward a new goal: finding the
PREVENTABLE causes of cancer, such as exposures to radiation and
certain chemicals, and who knows what else. As Devra Lee Davis says,
"Preventing only 20% of all cancers in the U.S. would spare more than
200,000 people and their families [each year] from this often
disfiguring and disabling disease and would also spare society the
burgeoning costs of treatment and care."

--Peter Montague, Ph.D.

=====

TABLE 1

U.S. Cancer Incidence and Deaths in 1989, and the Percent Change in
Age-Adjusted Rates of Incidence and Death per 100,000 U.S. Population,
1950-1989. . . -----ALL RACES------- ------WHITES--------- Cancer
Incidence Deaths Percent Percent type in 1989 in 1989 change in change
in . incidence, deaths, . 1950-1989 1950-1989
----- stomach 20,000 14,185 -73.5 -76.0 cervix 13,000 4,487 -76.0 -
73.9 colon/rectum 151,000 57,023 +10.0 -25.6 ovaries 20,000 12,256
+8.2 -0.2 larynx 12,300 3,727 +62.4 -10.1 testicles 5,700 392 +115.0
-66.4 bladder 47,100 10,121 +55.7 -35.6 Hodgkin's 7,400 1,721 +29.2 -
65.5 childhood cancers 6,600 1,768 +9.8 -61.1 leukemia 27,300 18,406
+7.8 -2.1 lung 155,000 137,013 +263.8 +245.2 skin 27,000 6,161 +321.0
+152.4 breast (female) 142,000 42,836 +52.5 +4.7 prostate 103,000
30,519 +108.8 +14.8 kidney 23,100 9,638 +109.4 +28.0 non-Hodgkin's
lymphoma 32,800 18,064 +158.6 +108.7 . All types ex- 855,000 359,117
+29.9 -19.4 cluding lung . All types 1,010,000 496,130 +44.3 +3.2
=====
Source: Lynn A. Gloeckler Ries and others, editors, CANCER STATISTICS
REVIEW 1973-1989 [National Institutes of Health Publication No. 92-
2789] (Bethesda, MD: National Cancer Institute, 1992), Table I-3, pg.
I.23. NIH says historical data for non-whites are not considered
reliable spanning the period 1950-1989 so historical data are only
given for whites.
=====

=====

[1] Devra Lee Davis and others, "Decreasing Cardiovascular Disease and
Increasing Cancer Among Whites in the United States From 1973 Through
1987," JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Vol. 271, No. 6
(February 9, 1994), pgs. 431-437. And see David Brown, "Baby Boom
Cancer Risk Up Sharply," WASHINGTON POST February 9, 1994, pgs. A1,
A11. See also Tim Beardsley, "A War Not Won; Trends in Cancer
Epidemiology," SCIENTIFIC AMERICAN Vol. 270 (January 1994), pgs. 130-
138.

[2] David G. Hoel and others, "Trends in Cancer Mortality in 15
Industrialized Countries," JOURNAL OF THE NATIONAL CANCER INSTITUTE
Vol. 84, No. 5 (March 4, 1992), pgs. 313-320.

[3] Lynn A. Gloeckler Ries and others, editors, CANCER STATISTICS
REVIEW 1973-1989 [National Institutes of Health Publication No. 92-
2789] (Bethesda, Md.: National Cancer Institute, 1992), Table I-3, pg.
I.23.

[4] See Susan Okie, "Smoking Addictive, Koop Confirms; New Warning
Label, Health Efforts Urged," WASHINGTON POST May 17, 1988, pg. A1.
Even tobacco health researchers funded by the tobacco industry describe
tobacco as addictive; in a government survey of 179 industry-funded
researchers, all but one described tobacco as "addictive." See "Tobacco
researchers say smoking harms," SCIENCE NEWS Vol. 140 (July 27, 1991),
pg. 59.

[5] An editorial in the same issue of JAMA notes that these four
cancers do not represent an "entirely pure" category of tobacco-related
cancers because some cancers of the bladder, kidney, pancreas, and
possibly cervix and stomach, may also be caused by tobacco. See Anthony
B. Miller, "How Do We Interpret the 'Bad News' About Cancer?" JOURNAL
OF THE AMERICAN MEDICAL ASSOCIATION Vol. 271, No. 6 (February 9, 1994),
pg. 468.

[6] Hans-Olov Adami and others, "Increasing cancer risk in younger
birth cohorts in Sweden," LANCET Vol. 341, No. 8848 (March 27, 1993),
pgs. 773-777.

[7] See, for example, John Gofman's unpublished paper linking female
breast cancer to radiation: "Ionizing Radiation and Breast Cancer,"
presented February 22, 1994 at the annual meeting of the American
Association for the Advancement of Science in San Francisco. Available
from: Dr. John Gofman, Committee for Nuclear Responsibility, P.O. Box
11207, San Francisco, CA 94101.

Descriptor terms: cancer statistics; morbidity; mortality; american
medical association; sweden; us; radiation; farmers; agriculture;
pesticides; solvents; sun; sunlight; uvb; ultraviolet radiation;
viruses; breast cancer; stomach cancer; cervical cancer; colon cancer;
rectal cancer; testicular cancer; bladder cancer; Hodgkin's disease;
non-Hodgkin's lymphoma; leukemia; childhood cancer; lung cancer; skin
cancer; prostate cancer; kidney cancer;