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W HItE EVIDENCE accumulates that the vast ma- Jorlty of cancers are environmental In orlgln, the government's f81SmUllon-a-year 'War on Gncer' b dominated by an outdated strategy aimed at curea rather than prevention. , lal category. ~ ' The origlps of this misemphasb Be in a Uttle•knowp ' and complex relationship between the government's Na- ~ tlonal Cancer Institute (NCI) - the "Pentagon" of the. War on Cancer - and the private but powerful Amerl- i can Cancer Society (ACS), whtch, among other things, serves as NCI's ministry of information for educating the public about cancer. One effect of their tro0ahora- tlon is the dominatlca of the curaUve stralegy, which Is akin to dealing with aviation disasters mainly by seeking to reconatryct wrecks rather than to prevent them. ' Under scientific and public pressure. NCI has been ihlfting additional resources to research Into the origins and prevention of cancer, but the movement has been ilow and the aums Involved are relatively ama11.7Lough NCI officials have publicly stated that environmental sources account for as much as 90 per cent of all cancetx - other estimates vary from 50 per cent upward - about 15 per cent of NCI's funds are In the envlroameno- +. f/oHl, who was then the associate director for cart'Inoge- ,;„. l: .. a! !;: ~'.:.: -'t the actual sum Is that high. Last year. Dr. Umberto Sat- '`{ ry° t ` . t: •r ( Privately, many NCI staff members express doubt that , , ' -r ^~`" • n-ta wmtw i Innm m-ranAnm In rl,- Pr.nl, I R.n.. ,.~ 1','... ',e-. '.' \' •" - I ',.... . MK.~ . . t.f'/ ; t rathcr than prevention. Its atrong campaign agalost cl- ~-------.-~--:•-"-+~ garetles Is a major exception, and there are a few othen, r' "i though of a pgnlticantly smaller scde. But in the maln t #. priorities should be in the quest to control cancer. The . r • ' ~ . AlS,manyofwhosadlrectonhavellawllhmaJorln- •~han onthe Enviranmente~I - ..Causes ~ dustrlee, plates the emphasb on dlagnwy and eurea; ~ 1* Ci I b a slightly Increased risk of her getting the disease to the distant future [as a result of X'ray exposure], there 1 also an excellent chance that by that time science will have learned to control the disease." The Digest failed to rote that X-rays actually have a - mixed record for detecting cancer, lhat unintrusive and harmless techniques, such as physlr.al examination, will -: often sufflce and that any foreseeable "conlrol" of breast cancer is likely to involve disfiguring surgery and harsh drugs. Nor was it mentioned that the author intep viewer of the article, Walter S. Ross, is a parPtime em• ployee of the ACS, which initiated and oversees the X- ray screening program. A Self-Lirtlitetl Role T 0 ITS CREDIT, the ACS has led the campalgn against cigarettes and recently has alerted the pub- lic and health officials to the carcinogenlc dangers of aa• beetos and vinyl chloride gas, although most of the as- bestos and vinyl cqloride research has been financed by the National Institute of Environlnental Health Sd- eoces, a sister agency of NCI in the National Institutes of I!ealth complex. But apart trom these and several minor ventures into the environmental control of cancer, 4CS has had the effect of diverting attention from iudustry: - For example, when a government-prodcced "cancer atlas" showwed that the disease tends to be most preva- lent In heavily Industrialized areas - with New Jersey cited as the most cancer-ridden - Lawrence Carfinkel,' the ACS assistant vice president for epiaemiulugy and r statistics, was quoted In kiedicai World Nexs as saying : that "The people in the lNew Jerseyl State ifcalth De- partment are promulgating an aura of cancer phobia to get money for studies." Questioned about the accuracy of the quotation. Cr,rn finkel said:'•1 was misquoted. What I did say was tl:at f1 I was In the health department and wanted to get aume- thing started, I might even do the same thing." He added: "I believe we can save more lives in 1977 by get- thenqnitth.paalfar.natheratheagencyn i: How tne Ameriean'~pnePyr/ ;Soci et~ ,.'-: While there Lt no question about the humane Intent of ~ all Involved, questions do arlse about the dominaUoo ot ' n o e u s es o n"S e a r~c h' f or C u r es"R a t h e r' ACS by a partlcular school of thought on whal the hamstrung by Insufficlent suff and reaourcea. SaffbtU t,.i:: r ~ •I • ' Colurrcn.ists Editorials ~ cnur, tnen auector ot nct, compummg ttul ne wae ~, ,,' moff. But oely Ill to 16 per eent of what ScUlkoff and J' qcreening. John G Baltar HI, the physlclanstaqstktan' •' ACS has shown little interest In the envloottmental ~ origine of cancer, many of which are in IndustrW pro ab colleagues have been spendhtQ In recent years has '~' i 7: who /s edltor-ptchlef of the prestigious Journal of the , cesxs and products. l.. been eontrlbuted by the Cancer Soclety. The test hai : National Cancer Institute, bas warned that the program ting people tp stop smoking than by a aepfedup anl.idn- dustrial campaign." ACS's widely puhliclred "Seven Waratng Signs of :• :, Cancer" are nnt supplemented by warnitlgs about la- ~duslrlal smokestacks or cautious about products other than cigarettes. Asked about this specifkally, Irving J. Rimer, ACS etimefromseveralfederalagencin,althoughnotNC1- t "contatns the seeds of a major disaster." Irwin D. L.' ' ` vice president for public information, uld that the ao-'; ~' F' ACS Influence over NCPs strategy and spending haa Bro.ss, Pd.D., dlrector of bfostatlstlcs at Buffalo's Roswell I !: clety bas "a very grave concern about looking for the art- ;', been Sffected through the soc/ety's represenuUon on , d l d d ' ' " " ` ` sory qo les that gul e the insUtule v J e ~1oe a • -s : , vironmenul causes of cancer and has long supported i vestlgaUona of Dr. Irving J. Sellikoff of New York's MC • Sinai Hospital, with whom Hammond often collaborates. :' A chock confirmed Hammond's long aasociaUon with ' Dr. Cuyler Hammond, and the occupational cancer In; *` .r <" vast program that some cancer specuUsts consider one I both the population studies of Its own epidemlologbt,' ; ,:% programs. The htfluence b extensive and Is typiti.,f by a t; Park 6lemorlal InsUtute, one ot the pation's leading cancgr research centers, has charged that: "ThI3 expo- sure to diagnostic X-ray will probably reiult in the worst.:_ . "talrogenic Idisease caused by medical treatmentj epl... of the major medical sc.ndab of all time: the joint NCI- delnic of breast cancer in bistory." . A(S breast cancer screening proJect. Against the advice , Neeertheless, the screening continues, only partially . of many of Its own staff and advisory experts, N~1 was abated, spurred on by an ACS publicity campaign desig. persuaded by A(5 m pay for more than four-fifths of ned to counter doubts as to Ita safety and utility. this tS( million underuking, lhe X-ray portion of whicb Methods used by the ACS to promote X-ray screening ' . -Greenberp is editor of a Washirtplon-baaed nemstet- has since been deemed possibly worthless as well as dan- employ oversimpllfications on a_ subject already bur- ter, Science & Government Report, and writes a gerous tq many of the 280,000 women who were drawn ' dened by fear and poor public understanding. - -eolrtmw on health eore politics for the New England In for exnminatlona. For example, in an Inlervlew In the March Reader's Journal ol dfedinne. Randol is Washinpton s~ience cor- , Since X-uys are a two-edged tool - they can lrigger' Digest, Dr. Benjamin F, Byrd.Jr.; Immediato past preal• ( respondent for the New York Doily News artd science : as weil na fllid caqcer - NCf has repeatedly bean ad deat of the AtS, notes that mammography (breast Xray '. polityeditoroJCfmrtprmapazine. - -asisedtosciledownandeventerminateludlacnmWate e ~eaaruinaliunlunsaveauoinanphfeand,"evenlfthere ; 1 . L *."000Iwxwsr . aw. 9ETss400oZ In the long and bitter struggle for passage of the Texle Substances Conlrol Act, a landmark law aim=d at ellml- nating hazardous chemicals, particularly carcinogens- from the envlronment, the ACS was a Iate and perfuuc- lory supporter. ACS did not testify on the legislation, and its Iciler ' urging 1'resldent Ford to approve the bill anived so close to the scheduled signing cereniony that it my ~; have gone unnoted. According to a top labor ufficial, took a gigantic effort" to get Al,'S to send the letter. The society played no role in the declsian by the Cun- .•' aumer Product Safety Commission to ban the flame re- tardant Tris from children's slaepwear beeause it has - been shown to be a carclnogen In anirnals, according to officials at the commission and scientists at the Envirun- mental Defcnse F'und, which goadad the cotnmtssion into ordering the ban. . See CANCER, l'age C4