Chicago
Tribune
Copyright 2003 Chicago Tribune
Date:
Tuesday, June 17, 2003
Edition: Chicago Final
Section: Commentary Page: 17 Zone: C
Source: By Samuel S. Epstein and Quentin D. Young. Dr. Samuel S. Epstein is
chairman of the Cancer Prevention Coalition and professor emeritus of
environmental and occupational medicine at the University of Illinois at Chicago
School of Public Health. Dr. Quentin D. Young is chairman of the Chicago-based
Health and Medicine Policy Research Group and a director of the Cancer
Prevention Coalition.
When
it comes to the safety of children, Americans are among the most cautious
parents in the world. We strap our kids into helmets and kneepads before letting
them coast down the block on their bikes. We cover electrical outlets with
plastic caps and make sure vehicle safety seats are securely installed,
backward-facing until our babies toddle past their first birthdays. When they
venture off to school, we teach our children not to speak to strangers, about
"bad touches" and how to dial 911.
Yet
when it comes to preventing the disease most likely to kill children, we seem to
be at a loss. Childhood cancer now strikes about 9,000 kids under the age of 15
yearly, with about 1,500 deaths.
What's
more, children are more likely than adults to have developed advanced cancer by
the time they are diagnosed. A startling 80 percent show signs at diagnosis that
the disease has spread elsewhere in the body. Just how old are these children
when diagnosed with cancer? The median age is 6.
Making
matters worse, the number of children diagnosed with cancer each year has been
rising dramatically. From 1975 to 2000, childhood cancers increased by 32
percent--36 percent in African-Americans--making cancer the biggest health
threat to our children, second only to accidents in its lethal impact.
Specifically, acute childhood lymphocytic leukemia is up 57 percent; brain
cancer, 50 percent; kidney cancer, 48 percent; and bone cancer, 29 percent.
Sadly,
many of these cancers could have been avoided. But parents remain uninformed
about the wide range of carcinogenic exposures that pervade the landscape of our
children's lives, seeping into their bodies through contaminated drinking water,
chemically preserved wooden playground sets, pediatric prescription drugs--even
the flea collar around Fido's neck.
Making
matters worse, parents have been kept in the dark about their own ability to
help protect children from these dangerous exposures.
Why?
Because the federal National Cancer Institute and the non-profit American Cancer
Society have never warned the public about the numerous consumer products and
other common exposures that can cause cancer in children, and also lead to
cancer in later life. They have also failed to warn the public that the
incidence of childhood cancer has been rising steadily for more than two
decades.
The
public has an undeniable right to know that there is strong reputable science
that links childhood cancers to exposures of the fetus, infants and children.
These avoidable exposures fall into four main categories: environmental (e.g.,
pesticides in drinking water and baby food and from urban and school spraying of
pesticides); occupational (e.g. maternal exposure during pregnancy to
carcinogens in the workplace); domestic and household (e.g., nitrite-preserved
hot dogs, pesticide use in the home and lawn and shampoos and lotions with
carcinogenic ingredients); and medical (e.g., Ritalin, commonly prescribed for
attention deficit disorders).
Notwithstanding
substantial contrary evidence, the ACS dismisses cancer risks from exposure to
dietary pesticides, hazardous waste sites, and radiation from nuclear power
plants as "negligible." The ACS 2003 "Cancer Facts &
Figures," in its section on childhood cancer, makes no reference at all to
any causes.
The
NCI takes the same head-in-the-sand approach. "The causes of childhood
cancer are largely unknown," the federal organization flatly asserts. Never
mind that this simply isn't so.
The
failure of the NCI and ACS to inform the nation of the risks from carcinogenic
exposures has also resulted in a failure to regulate such exposures. For
example, the Environmental Protection Agency's Scientific Advisory Board is now
developing new guidelines for regulating risks from "early-life exposure to
carcinogens."However, the EPA is only considering isolated risks of
individual carcinogens in air and water, rather than assessing their multiple
and cumulative impact, besides numerous unrelated exposures to carcinogens under
the jurisdiction of the Food and Drug Administration and other regulatory
agencies.
Because
of their smaller size, lower body weight, and faster metabolism, children,
infants, and, even more so, the fetus, are far more vulnerable to carcinogenic
and toxic exposures than adults--a fact recognized by President Bush during his
candidacy but apparently forgotten once he took office. At that point, federal
spending for children's health programs at the EPA fell by a solid--and
shameful--10 percent.
The
lack of research and public information stems not from a lack of resources, but
from imbalanced national policies. Since passage of the 1971 National Cancer
Act, which called on NCI to undertake research and provide the public with
information on the causes and prevention of cancer, its annual budget has
escalated to $4.6 billion from $220 million. While NCI's budget was growing, so,
paradoxically, was the incidence of childhood cancer, along with non-smoking
related adult cancers. Yet NCI spends less than 4 percent of its $4.6 billion
budget for research and public information on avoidable causes of cancer, while
the ACS spends less than 1 percent of its $800 million from public support
(excluding income from government grants and investments from $1 billion
reserves) on environmental and other causes. The overwhelming majority of NCI
and ACS funds are dedicated to screening, diagnosis and treatment of
cancer--obviously worthy pursuits, but ones that would become much less crucial
were they to devote more equitable resources to prevention and public education.
Parents cannot protect their children from threats they know little or nothing about. Clearly, the time for open public debate and congressional oversight of national cancer policy is long over-due.