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Oct. 23 —
The
National Cancer Institute has released some eye-opening new figures
revealing that not only is the United States not winning the war on
breast cancer, but the enemy has been gaining on us over the past 15
years. That has prompted environmental health advocates to demand
more and better research into the possible role of pollutants,
radiation and other environmental factors in driving the dreaded
disease. |
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FORGET THE San Andreas
Fault. The news that Marin County, Calif., had seen a skyrocketing
increase in the incidence of breast cancer unleashed an earthquake
of concerns.
Breast cancer jumped by 72 percent among Marin women ages 46
to 64 during the 1990s, according to a May report in the journal
Breast Cancer Research.
“These high rates set off a mobilization of people from
throughout the Bay Area to work together on solving this medical
crisis,” says Fern Orenstein, a board member of Marin Breast Cancer
Watch, a local nonprofit group that has sponsored community forums
attended by thousands of residents as well as researchers.
“While most cancer researchers discount the role of the
environment, that’s about 95 percent of what people in the community
talk about,” says Orenstein. Local concerns range from the possible
roles of radioactive dumping and nuclear submarines in the San
Francisco Bay to hazardous chemicals in Richmond Harbor to toxic
fuel from jetliners and pesticides on suburban lawns. |
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Here, as in many places,
relatively little research has focused on possible environmental
links to the disease. But last week, California received nearly $1
million from the federal Centers for Disease Control and Prevention
to plan a surveillance system to track chronic disease and its links
to the environment. It is one of 20 states beginning to do such
tracking.
STATE OF THE SCIENCE
In August, two groups, The Breast Cancer Fund and Breast
Cancer Action, released
“The State of the Evidence,” a report compiling results from
many studies that they say already show links between environmental
toxins and breast cancer. Among the findings: Common pollutants,
such as benzene, a compound found in car exhaust, are linked to
breast tumors, and people who move to industrialized counties
suddenly face a higher breast cancer risk within one generation.
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But
critics complain that research institutions haven’t focused enough
on this kind of investigation.
Federal cancer research spending has increased dramatically,
from $90 million in 1990 to $800 million in 2001, but less than 3
percent of those dollars have been focused on finding environmental
links to breast cancer, according to the National Breast Cancer
Coalition.
The American Cancer Society, for example, downplays the
possible connection. “Currently, research does not show a clear link
between breast cancer risk and exposure to environmental
pollutants,” the society says on its Web site. While acknowledging
that some studies have suggested links, the society insists that
these likely account for only “a small portion of breast cancer
cases.”
And some activists fear the National Cancer Institute (NCI)
is unlikely to invest significantly in more environmental research
since its expensive effort with the
Long Island Breast
Cancer Study . By far the biggest investment of its kind,
costing $30 million over nine years, the project was a multistudy
attempt to investigate whether pollution was responsible for high
rates of the disease in several New York counties. The NCI concluded
earlier this year that pesticides such as DDT were not linked to
breast cancer on Long Island. |
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But Brenda Edwards, associate director for the NCI’s
surveillance research program in Bethesda, Md., dismisses such
concerns: “NCI has and will continue to fund research on the causes,
diagnosis, detection, treatment, survivorship and surveillance of
cancer. This has included and will continue to include
investigations related to health-related environmental factors,” she
says.
The Long Island study has been heavily criticized, however,
for failing to look at more relevant chemicals than long-banned
compounds as well as at potential radiation exposure. |
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“The
Long Island study results were confused, but the growing breast
cancer numbers and the Marin County data certainly should trigger
very hard discussion of [prevention-oriented research] at the
highest levels,” says Dr. Phillip Lee, a former assistant secretary
for the U.S. Department of Health and Human Services, now an
emeritus professor of medicine at the University of California, San
Francisco. |
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The NCI’s latest numbers, released this month,
show that the agency had previously underestimated the incidence of
cancer in the United States. In the case of breast cancer, new
diagnoses have, in fact, been growing at a rate of .6 percent per
year nationwide.
QUESTIONS ON RISING
RATE
Some activists expressed outrage at the new NCI numbers and
said they were a further argument for investigating as-yet unstudied
environmental factors.
“Every year, there’s a press release about how we’re winning
the war on cancer. We’ve been warning for years that the emperor has
no clothes. Now the emperor has just stood up on stage naked and
said, ‘Whoops!’” says Barbara Brenner, director of Breast Cancer
Action. |
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Adds Shelley Hearne,
director of the nonprofit advocacy group Trust for America’s Health:
“The discovery that several common forms of cancer are rising — not
declining or leveling off as previously thought — reveals serious
shortcomings in the way this country keeps track of cancer and other
chronic diseases.”
"Something environmental has to be going on, since we haven’t had
a steady change in genes of such magnitude,” she says.
The NCI’s Edwards, however, attributes the increase to better
early-stage detection, and a miscalculation caused by delays in
hospitals’ reporting patient data. She adds that breast cancer
deaths will continue rising as the population ages. |
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“If you look at what we
know today, the greatest risk is due to reproductive factors ... as
well as lifestyle factors like alcohol and smoking,” she says. “If
[the environmental component] is there, it’s very hard to measure,
especially exposure over time. It’s not that I want to discount the
environment, it’s just that it’s very difficult to study.”
Dale Sandler, deputy chief of the epidemiology branch at the
National Institute of Environmental Health Sciences, thinks the
increase in breast cancer, while not drastic, deserves more study.
“With correction for error and the now statistically significant
trend, it will be less easy to be complacent,” Sandler says. The
fact is, she admits, “we have very little information on the
potential role of environmental exposures in breast cancer risk, and
more research is needed.”
Francesca Lyman is an environmental and travel journalist
and author of “Inside the Dzanga-Sangha Rain Forest” (Workman,
1998).
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