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---April 14, 1994---
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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.


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 typeIncidence in 1989Deaths in 1989Percent change in incidence, 1950-1989Percent change in deaths, 1950-1989
stomach20,00014,185-73.5- 76.0
cervix 13,000 4,487-76.0- 73.9
ovaries20,00012,256 +8.2-0.2
larynx 12,300 3,727+62.4-10.1
testicles 5,700 392 +115.0-66.4
Hodgkin's 7,400 1,721+29.2- 65.5
childhood cancers 6,600 1,768 +9.8-61.1
leukemia 27,30018,406 +7.8 - 2.1
lung155,000 137,013 +263.8 +245.2
skin 27,000 6,161 +321.0 +152.4
breast (female) 142,00042,836+52.5 +4.7
prostate103,00030,519 +108.8+14.8
kidney 23,100 9,638 +109.4+28.0
non-Hodgkin's lymphoma 32,80018,064 +158.6 +108.7
All types excluding lung 855,000 359,117+29.9-19.4
All types1,010,000496,130+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; u.s.; us; radiation; farmers; agriculture; pesticides; solvents; sun; sunlight; uv; uvb; ultraviolet radiation; viruses; breast cancer; stomach cancer; cervix cancer; colon cancer; rectal cancer; testicular cancer; bladder cancer; Hodgkin's disease; non-Hodgkin's lymphoma; leukemia; childhood cancer; children; lung cancer; skin cancer; prostate cancer; kidney cancer;

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