Cancer as an Environmental Disease


P Nicolopoulou-Stamati, L Hens, CV Howard, N Van Larebeke (Eds)
Springer Netherlands (2004)
ISBN 1-4020-2019-8  199 pages plus index
RRP: $US98.00

Consider the dichotomy consequent upon the word, ‘however’ (not bolded in the original) in the following paragraph from the volume under review:

The predominant theory for the past 50 years has been that cancer is the result of cumulative mutations that alter specific locations in the cells DNA and which alter the proteins encoded by cancer-related genes. Susceptibility to mutation has been mainly researched with respect to peoples genetic makeup and their lifestyle, which are largely dictated by behavioural patterns. However a growing body of scientific evidence strongly implicates the environment in the causation of cancer. Findings from studies of wildlife, cancer trends, human migration, childhood cancers, twinning and industrial accidents suggest that concentrating solely on genetic origin and behavioural pattern as causes of DNA defects, and consequently the main causes of cancer needs to be re-evaluated.

Arguably, the dichotomy suggested does not, in fact, exist because, amongst other things, environmental causes of cancer specifically include the impact of lifestyle, and differences in cancer incidence in migrant groups are attributable to behavioural patterns. But the distinction described is crucial to the editors and some contributors to ‘Cancer as an environmental disease’. For these individuals, there is the perception that implicating ‘lifestyle’ and ‘behavioural’ factors in the causation of cancer is akin to a ‘blame the victim’ and is incompatible with attributing cancer to industrial pollution and occupational exposures.

In the first three chapters of this book the notion that ‘environment’ can be separated from ‘lifestyle’ as accounting for cancer causation is pursued at the cost of scientific clarity. No attempt is made to present a clear distinction between the molecular genetic basis of inherited cancer and the molecular genetic explanation for malignant transformation. Increasing incidences of breast and prostate cancers (in Norway) is presented as being attributable to increasing pollution, without any reference to the possible impact of mammography and PSA testing on these trends.

Apart from those chapters concerned with a political agenda, some contributions are most informative. These include the discussion of gene-environment interaction, DNA damage induced by carcinogens and the health impact of accidents involving carcinogen exposure. However, the volume cannot be described as a reasonable assessment of environmental carcinogenesis because key issues such as the role of tobacco, alcohol and ultraviolet exposure are not addressed. People likely to benefit from this volume are individuals who seek to refine their current knowledge of particular issues rather than those hoping to gain an overall assessment of the topic ‘environmental carcinogenesis’.

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