The President's Cancer Panel Report: The Implications for Reforming our Nation's Policies on Toxic Chemicals
In a groundbreaking report released in May of 2010, the
President’s Cancer Panel provided strong confirmation
that exposure to toxic chemicals is an important and under-recognized risk factor for cancer, and recommended
that the Government take immediate action to reverse this
trend. The report, titled “Reducing Environmental Cancer
Risk: What We Can Do Now” opens with the observation that
“. . . the true burden of environmentally induced cancer has
been grossly underestimated.” The report goes on to say that
our government agencies are “failing to carry out their responsibilities”
and concludes with specific recommendations for
overhauling our nation’s flawed chemicals management system.
Acknowledging the devastating toll that a cancer diagnosis
takes on an individual and a family, the report urges policymakers
to shift their focus to reducing environmental cancer risk and
enacting stronger chemical regulations. Indeed, the Panel highlighted
the need for Congress to reform the Toxic Substances
Control Act (TSCA), commenting that this law is “the most
egregious example of ineffective regulation of chemical contaminants”
and noting that weaknesses in the law have constrained
EPA from being able to properly regulate known carcinogens
such as asbestos and formaldehyde. The report calls for legislation
that shifts the burden of proof from the government to
industry, requiring manufacturers to prove the safety of new
and existing chemicals.
Cancer in America: The report in context
The President’s Cancer Panel report provides an annual
update on the status of the National Cancer Program, also
known as the “War on Cancer.” Previous Panel reports
have focused on how factors like poor diet or smoking
can affect cancer rates. This report intentionally focuses
narrowly on environmental factors linked to cancer.
- The lifetime chance of a man developing an invasive
cancer is about one in two, and approximately one in
four men die from cancer. For women, the lifetime
chance of developing an invasive cancer is one in
three, and one in five will die from cancer.
- Cancer is the second most common cause of death
in the U.S., exceeded only by heart disease. More than
1.5 million people were diagnosed with new cases of
cancer in 2009.
- In 2009, cancer cost the nation $99 billion–$243.4
billion for direct medical costs, $19.6 billion for cost
of lost productivity due to illness, and $124.8 billion
for cost of lost productivity due to premature death.
Over the past two decades, the rates of some cancers
rose significantly. These include:
- Kidney, liver, thyroid, esophageal, and testicular
cancer, as well as melanoma in men.
- Non-Hodgkin’s lymphoma, Hodgkin’s disease,
melanoma, and cancers of the thyroid, liver, and
kidney in women.
- Childhood cancers overall, especially childhood
leukemia and brain cancer.
The report is based on testimony from dozens of experts
in cancer, toxicology, and public health, and the 200-page
document references hundreds of peer-reviewed scientific studies
to validate their recommendations. Report authors LaSalle D.
Lefall, Jr., M.D., F.A.C.S., of Howard University College of
Medicine and Margaret L. Kripke, Ph.D., professor emeritus
at the University of Texas M.D. Anderson Cancer Center,
were appointed by President George W. Bush.
The Panel emerged from their two-year fact-finding mission
with a strong sense of urgency, as expressed in their message to
. . . the grievous harm from this group of carcinogens has
not been addressed adequately by the National Cancer Program.
The American people—even before they are born—are bombarded
continually with myriad combinations of these dangerous
exposures. The Panel urges you most strongly to use the power
of your office to remove the carcinogens and other toxins from
our food, water, and air that needlessly increase health care costs,
cripple our Nation’s productivity, and devastate American lives.
The report also rejects out-of-date assumptions about environmental
causes of cancer and single chemical toxicity testing.
The widely quoted estimates of avoidable cancer deaths due
to environmental factors developed by Doll and Peto in 1981
(and estimated in similar later studies using the same methodology)
are woefully out of date, given our current understanding of
cancer initiation as a complex multifactorial, multistage process.
In virtually all cases, regulations fail to take multiple exposures
and exposure interactions into account.
New report puts spotlight on science
linking cancer to chemicals
Among the problem chemicals highlighted in the report:
- Asbestos—used in building and automotive materials
and known to cause several types of cancer, including
mesothelioma. In industrialized nations such as the
U.S., nearly one in three people with mesothelioma
have no history of workplace exposure to asbestos.
- Bisphenol A (BPA)—a widely used plastic and epoxy
resin component. Extensive research has linked BPA to
cancer, early puberty, altered brain development, metabolic
disturbances, and other serious medical problems.
- Chromium—used in chrome plating and other metal
production, dyes and inks, and leather tanning. Workers
exposed to chromium at risk for lung, nasal, and
nasopharyngeal cancers. In addition, inappropriate disposal
of industrial wastes has contaminated many drinking
water sources with hexavalent chromium which has
also been linked to cancer.
- Formaldehyde—a preservative commonly used in
pressed wood products, textiles and personal care products.
Formaldehyde is known to cause cancers of the nasal
cavity and nasopharynx and has been linked to leukemia.
- Mercury—released as by-product of industrial pollution
and used to produce batteries, thermometers, and
skin creams and ointments. Methylmercury persists in
the environment and accumulates up the food chain.
People are exposed to mercury when they eat contaminated
fish. In addition to being a known neurotoxin,
mercury is also suspected of causing cancer.
- Perchloroethylene (PERC)—used by approximately
28,000 dry cleaners in the U.S. and a common drinking
water contaminant. PERC has been linked to cancer and
workers inhaling perc are also at risk for liver damage
and neurological problems.
- Phthalates—commonly used to soften plastics or to
add fragrance to personal care products. Animal studies
link phthalate exposure in the womb to a greater risk of
infertility, genital birth defects, and testicular cancer.
- Trichloroethylene (TCE)—an industrial solvent frequently
found at hazardous waste sites that contaminates
up to a third of U.S. drinking water supplies.
Research has strongly linked TCE exposure to multiple
types of cancer.
See our coalition’s report “The Health Case for Reforming
the Toxic Substances Control Act” for a thorough overview
of how researchers are linking toxic chemical exposure
to a variety of major public health problems, including
Summary of recommendations for policy makers
Below we have summarized the President’s Cancer Panel’s recommendations
for policymakers. Read the report here.
- The full extent of environmental influences on cancer must
be better understood.
- The nation needs a comprehensive, cohesive policy agenda
regarding environmental contaminants and protection of
- Children are at special risk for cancer due to environmental
contaminants and should be protected.
- Existing regulations for environmental contaminants need
to be enforced and updated; stronger regulations are needed.
- Workers, and other populations with known exposures, and
the general public require full disclosure of knowledge about
environmental cancer risks.
- Safer alternatives to many currently used chemicals are
Mortality from childhood cancers has dropped dramatically
since 1975 due to vastly improved treatments that have resulted
from high levels of participation by children in cancer treatment
clinical trials. Yet over the same period (1975–2006), cancer incidence
in U.S. children under 20 years of age has increased.
Breast cancer rates in the U.S. increased by more than 40%
between 1973 and 1998, and though in the last several years
there has been a slight decline in breast cancer incidence,
it remains one of the leading causes of death in women.
IARC criteria for assessing cancer causation
due to environmental exposures
- The link or association between the exposure and cancer
- The risk of cancer increases with more exposure to the
- Multiple studies by different investigators with different
groups of people yield the same finding.
- The exposure to the agent came before the cancer.
- There is a plausible biological explanation for how the
agent would cause the cancer.
- The link is specific, and the agent causes a specific
type of cancer.
- The link is consistent with what is known from other
Sources: International Agency for Research on Cancer. IARC monographs
on the evaluation of carcinogenic risks to humans—preamble. Lyon, France:
IARC; 2006, and Emanuel EJ. Will your cell phone kill you? The New Republic.
2008 April 9.
It’s time for Congress to take action
The Safer Chemicals, Healthy Families coalition and key members
of Congress share the Panel’s concerns. In 2010 both the
House and the Senate introduced legislation to overhaul TSCA.
Both proposals include many of the same recommendations
made by the Panel. Common sense reform would:
- Shift the burden of proof by holding industry responsible
for demonstrating a chemical’s safety.
- Require chemical manufacturers to provide basic health
and safety information (including known cancer risks) for all
chemicals as a condition for remaining on or entering into
- Set health standards to protect vulnerable populations like
children and people living in environmental “hot spots.”
- Contain provisions that would boost efforts to find nontoxic,
greener alternatives to toxic chemicals.
This report marks the first time in its more than 40-year history
that the President’s Cancer Panel has addressed the role of environmental
contaminants in cancer incidence. As the Panel’s far reaching
recommendations make clear, to win the war on cancer
and protect public health, there must be a greater focus on precaution
and prevention of known carcinogens in the environment,
including toxic chemicals.
The Safer Chemicals, Healthy Families coalition includes nurses, parents, advocates for the learning disabled,
scientists, environmental health advocates, and concerned citizens from across the nation. These diverse groups are united
by their common concern about toxic chemicals in our homes, places of work, and products we use every day.