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- Indifference and hostility to prevention
- Conflicts of interest
The American Cancer Society (ACS) has not only remained silent about known carcinogens from our midst, it has lent its considerable influence and media muscle to help industry trivialize such risks. Thumbing its nose at an impressive body of legislative and regulatory precedents such as the Delaney amendment, which until 1996 banned the addition of known carcinogens to food products, the ACS has consistently rejected the relevance of animal evidence as predictive of human risk. (In direct contradiction to previous ACS protests and statements, Eyre claims the Society had not supported Delaney because it "was just not strong or potentially effective enough.") When studies unequivocally proved in 1971 that diethylstilbestrol (DES) caused vaginal cancers in teenage daughters of women who had taken the drug during pregnancy, the ACS refused to testify at congressional hearings on whether the FDA should ban the drug's use as an animal-feed additive. (It had long ignored evidence that DES is a potent carcinogen in rodents, known since 1939.) And in 1977, the ACS called for a congressional moratorium on the FDA's proposed ban on saccharin, going so far as to advocate its use by nursing mothers and babies in "moderation" despite clear-cut evidence of its carcinogenicity in rodents and very suggestive evidence of bladder cancer in humans.
Backing the cosmetics industry in 1977 and 1978, the ACS fought proposed regulations for permanent dark hair-coloring products containing dyes known to cause breast cancer in animals, and now implicated as a cause of non-Hodgkin's lymphoma and other cancers. In 1982 it formally codified its insistence on unequivocal human evidence of carcinogenicity before speaking out against potential public health hazards, ignoring virtually every tenet of responsible public health policy. The Society, however, apparently has no problem defending chemicals or products when no such proof of their safety exists. In 1992, the ACS issued a joint statement with the Chlorine Institute in support of the continued global use of organochlorine pesticides, despite evidence that some were known to cause breast and other cancers. And in 1996, it joined a diverse group of patients and physician groups to file a petition against the FDA to ease restrictions on silicone breast implants. The ACS failed to disclose industry studies that showed the gel in the implants induced cancer, and that the implants were contaminated with known carcinogens such as ethylene oxide and crystalline silica.
In its latest annual report, Cancer Facts & Figures 2002, the ACS reassures that cancer risks from dietary pesticides, hazardous waste sites, ionizing radiation from "closely controlled" nuclear plants, and non-ionizing radiation are all at such low levels as to be "negligible." Despite a promise of "cancer facts," the ACS neglects to inform the public about a number of well-documented cancer risks. Among them: dusting the genital area with talc increases risk of ovarian cancer; home and garden use of pesticides, consumption of nitrite-preserved hot dogs contaminated with the highly potent carcinogen nitrosamine are well-recognized risk factors for childhood leukemia and brain cancer; and animal and dairy fats and mainstream produce are exposing consumers to a wide range of carcinogenic pesticide residues, unlike safer organic foods.
History of ACS Indifference and Even Hostility to Prevention
- In 1971, when studies unequivocally proved that diethylstilbestrol (DES) caused vaginal cancers in teenaged daughters of women administered the drug during pregnancy, the ACS refused an invitation to testify at Congressional hearings requiring the FDA to ban its use as a growth promoting hormone for cattle in feedlots.
- In 1977 and 1978, the ACS opposed regulations proposed for black or dark brown hair coloring products, containing coal tar dyes known to cause breast and liver cancer in rodents, in spite of evidence of human risk.
- In 1977, the ACS called for a Congressional moratorium on the FDA’s proposed ban on saccharin, and even advocated its use by nursing mothers and babies in "moderation," despite clear-cut evidence of its carcinogenicity in rodents.
- In 1978, Tony Mazzocchi, then senior representative of the Oil, Chemical and Atomic Workers International Union, stated at a Washington, D.C. roundtable between public interest groups and high-ranking ACS officials: "Occupational safety standards have received no support from the ACS."
- In 1978, Congressman Paul Rogers censured the ACS for doing "too little, too late" in failing to support the Clean Air Act.
- In 1982, the ACS adopted a highly restrictive cancer policy that insisted on unequivocal epidemiological evidence of carcinogenicity before taking any position on public health hazards. Accordingly, the ACS still trivializes or rejects evidence of carcinogenicity in experimental animals, and has actively campaigned againstlaws (the 1958 Delaney Law, for instance) that ban deliberate addition to food of any amount of any additive shown to cause cancer in either animals or humans.
- In 1984, the ACS created the October National Breast Cancer Awareness Month, funded and promoted by Zeneca, an offshoot of the U.K. Imperial Chemical Industry, a major manufacturer of petrochemical products. The ACS leads women to believe that mammography is their best hope against breast cancer. A recent ACS advertisement promised that "early detection results in a cure nearly 100% of the time." Responding to questions from a journalist, an ACS communications director admitted: "The ad is based on a study. When you make an advertisement, you just say what you can to get women in the door. You exaggerate a
point. Mammography today is a lucrative [and] highly competitive business." Even more seriously, the Awareness Month publications and advertisements studiously avoid any reference to the wealth of information on avoidable causes and prevention of breast cancer.
- In 1992, the ACS supported a statement by the Chlorine Institute defending the continued global use of organochlorine pesticides—despite clear evidence of their persistence and carcinogenicity. Society Vice President Clark Heath, M.D., dismissed evidence of this risk as "preliminary and mostly based on weak and indirect associations."
- In 1992, the ACS launched the breast cancer "chemoprevention" program, in conjunction with the NCI, aimed at recruiting 16,000 healthy women at supposedly "high risk," into a 5-year clinical trial with the highly profitable drug Tamoxifen, manufactured by Zeneca. Evidence of the claimed effectiveness of Tamoxifen is, at best, arguable. Furthermore, evidence of the drug's life-threatening adverse effects in healthy women is trivialized. More seriously, information that Tamoxifen poses grave risks of liver cancer, as it is a highly potent liver carcinogen in rats in whom it also induces irreversible DNA adducts, remains undisclosed to women recruited into clinical trials.
- In 1992, The Chronicle of Philanthropy, the nation’s leading charity watchdog, warned that the ACS was “more interested in accumulating wealth than in saving lives.”
- In 1993, just before PBS aired the Frontline special entitled, "In Our Children’s Food," the ACS came out in support of the pesticide industry. In a damage-control memorandum, sent to some 48 regional divisions and their 3,000 local offices, the ACS trivialized pesticides as a cause of childhood cancer. ACS also reassured the public that food contaminated with residues of carcinogenic pesticides is safe, even for babies. When the media and concerned citizens called ACS, they then received reassurances crafted by Porter-Novelli, a powerful PR firm for the agribusiness industry and then rehashed and sent to another client, the ACS: "The primary health hazards of pesticides are from direct contact with the chemicals at potentially high doses, for example, farm workers who apply the chemicals and work in the fields after the pesticides have been applied, and people living near aerially sprayed fields. The American Cancer Society believes that the benefits of a balanced diet rich in fruits and vegetables far outweigh the largely theoretical risks posed by occasional, very low pesticide residue levels in foods." In support of this ACS-agribusiness initiative, these reassurances were then rehashed for a third time by the right-wing group, Accuracy in Media (AIM), which published quotes from the ACS memorandum in an article with the banner headline: “Junk Science on PBS,” with an opening, “Can we afford the Public Broadcasting Services?”
- In February 1994, the ACS published a study designed to reassure women on the safety of dark permanent hair dyes and trivialize risks of fatal and non-fatal cancers, as documented in over six prior reports. However, the ACS study was based on a group of some 1,100 women with an initial age of 56 who were followed for seven years only. The ACS concluded that "women using permanent hair dyes are not generally at increased risk of fatal cancer." However, risks of cancer in women over 63 are up to 20 times higher for non-Hodgkin's lymphoma and multiple myeloma, 34 times for bladder cancer, and 8 times for breast cancer. As designed, the ACS study would have missed the great majority of these cancers, and excluded dark hair dyes as important risks of avoidable cancers.
- In September 1996, the ACS together with patient and physician organizations, filed a "citizen’s petition" to pressure FDA to ease restrictions on access to silicone gel breast implants. What the ACS did not disclose was that the gel in these implants had clearly been shown to induce cancer in several industry rodent studies, and that these implants were also contaminated with other potent carcinogens, notably ethylene oxide and crystalline silica.
- In 1998, ACS allocated $330,000, under 0.1% of its $678 million revenues, to research on Environmental Carcinogenesis, while claiming allocations of $2.6 million, 0.4% of its revenues. Furthermore, in its annual publication, Cancer Facts & Figures, designed to provide the public and medical profession with "basic facts" on cancer, other than information on incidence, mortality and treatment, there was little or no mention of primary prevention. For breast cancer, ACS stated: "Since women may not be able to alter their personal risks factors, the best opportunity for reducing mortality is through early detection."
- In May 1999, the ACS issued a statement trivializing cancer risks from consumption of genetically engineered, rBGH/BST, milk containing high levels of the growth factor IGF-1. This reassurance wasin striking contrast to substantial published scientific evidence that elevation in blood levels of IGF-1 are strongly associated with excessrisks of breast, colon and prostate cancers.
- In the January 21, 2000, Cancer Letter, commenting on the ACS behind the scenes creation of a Legislative Committee to gain major control of national cancer policy, Dr. John Durant, former executive President of the American Society of Clinical Oncologists, charged: “It has always seemed to me that was an issue of control by the ACS over the cancer agenda. They are protecting their own fundraising capacity . . .” from competition by survivor groups.
- In the January 28, 2000, Cancer Letter, it was revealed that the ACS had close ties to the tobacco industry. Shandwick International, representing R.J. Reynolds Holdings, and Edelman, representing Brown & Williamson Tobacco Company, have been major PR firms for the ACS in its attempts to rewrite the 1971 National Cancer Act, and in conducting voter education programs in the past presidential campaign.
- In the ACS Cancer Facts and Figures 2002, the Community Cancer Control Section includes a “Look Good … Feel Better program to teach women cancer patients beauty techniques to help restore their appearance and self-image during chemotherapy and radiation treatment.” This program is partnered by the National Cosmetology Association and The Cosmetic, Toiletry and Fragrance Association Foundation, which have failed to disclose the wide range of carcinogenic ingredients in toiletries and cosmetics. These trade organizations have also failed to disclose evidence of excess risks of breast and other cancers following long-term use of black or dark brown permanent and semi-permanent hair dyes. The ACS has failed to inform women of these avoidable risks.
- In the ACS Cancer Facts and Figures 2002, the Environmental Cancer Risk Section dismissively reassures that carcinogenic exposures from dietary pesticides, "toxic wastes in dump sites," ionizing radiation from "closely controlled" nuclear power plants, and non-ionizing radiation, are all "at such low levels that risks are negligible."
The ACS track record on primary prevention is likely to be perpetuated in future policies of the NCI following the February 2002 appointment of Dr. Andrew Von Eschenbach as NCI Director; prior to this, Von Eschenbach was President-Elect of the ACS. Furthermore, as a condition of appointment as NCI Director, Von Eschenbach continued his leadership of the National Dialogue on Cancer.
Excerpted from “The High Stakes of Cancer Prevention” by Samuel Epstein and Liza Gross, Tikkun Magazine, Nov/Dec 2000www.tikkun.org
For more detailed and updated information, see
The Stop Cancer Before It Starts Campaign: How to Win the Losing War Against Cancer, 2003
Samuel S. Epstein, M.D., Chairman
Cancer Prevention Coalition
2121 W. Taylor St., M/C 922
Chicago, IL 60612