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R&S 109656 1* BIO-MEDICAL RESEARCH < DOCUMENT DESCRIPTION FORM g3 68 69 n n O n n A j Duplicate in all cards:--} [ft* year as-1961- File number [Right justify [Numeric only] Author(s), as Last Name FS (No Punctuation) and coden for journal as JAMA preceeded by one blank space P5T*. /? 20 21 1 40 41 I 77 78 I >< Sub-Index Code 60 61 62 11 12 13 Title of Report; end with space-hyphen-hyphen-space. Follow with Index Terms, separated from each other with comma-space. Avoid other punctuation; do not abbreviate. 1-- ,0 />~,9 tfvrx-c'/o*/-- &s'a/ VC Sf&SZ? ^ > zm, viTT, ASy/Wy/s l/-5~C>J a-u/? 6r~ 21 22 23 24 Source (Journal, Vol., Number, Pages, Date ) 12 vyy 7y?-y & /v^ 1 ,/ 61 62 31 32 Brief Summary 12 10 SWIMARY: 61 62 61 62 63 64 HEALTH & ENVIRONMENTAL SCIENCES, U.S.A. 8/21/80 E. H. Blair, 2020 Dow Center R. R. Cook, 1803 Building P. J. Gehring, 2020 Dow Center M, N. Johnson, The B.F. Goodrich Company C. Tamburo, University of Louisville I came across this article again recently. It may be of interest to you. I FROM: T. R. TORKELSON 1803 Building 517/636-5197 PO Box No 6 Bessemer Road Welwyn Garden City Hertfordshire AL7 1HD Telephone Welwyn Garden 23400 (STD Code 07073) Telex 264251 From To J Stafford Division Manager Health & Environment Protection DSO 16 See circulation below Copies to Imperial Chemical Industries Limited Plastics Division Your ref. Our ref JS/TAO/DSO 16 Tel ext 3162 Date 2 May 1980 VCM - POLITICS OP CANCER In the UK some of our unions are using Prof. Epstein1 s "Politics of Cancer" as a Bible. The book will be published here in paperback form in a few weeks. You may be interested to have a copy of the attached article in Nature 27 March 1980 pages 297-300 by Richard Peto who works with Sir Richard Doll. The article is not pro-industry but it is a good appraisal of the Epstein book and an excellent plea for balance. R&S 109657 enc Circulation Mr G J Sleddon Dr V G F Adams (4for associates) Dr D V Plester Mr Owen Jones Dr B Bennett Mr D Bartholomew Mr J Colchester Dr D P Duffield Dr I Purchase Dr D Bryson Dr A P Wright Dr F W Best Mr R Hards Mr 3 Easier Mr A E H Williams Mr T L Phillips Dr P Lewis Mr B N P Hutchesson Mr W McMillan Mr C N Lewis Dr D Parker Mr M Vincent Dr J Stafford Mr M J S Gibbons Dr D M Ferguson Mr J Kolcun Mr D Ryerson Dr J G Kammuller Mr J C Thomas Dr R Mattiussi Dr J P Tassignon Mr M Bonnefoy Mr P G Claus Dr B List Mr H Emminger Dr J Possberg Mr M Munez Mouton Dr T Garlanda Mr P Rangnes Mr S Wejdling Mr 0 Eansanen Mr J Lawrence Dr T R Torkelson Mr Joe Hadley Dr D Scarisbrick Mature VoL 284 27 March 1980 I 0003247 297 Distorting the epidemiology of cancer the need for a more balanced overview The politics of cancer are becoming increasingly polarised with environmentalists taking one extreme view and industrialists the other. Richard Peto argues that a more dispassionate and disinterested approach is required for a realistic assessment both of the risks from environmental carcinogens and of the preventative regulations needed THERE exist, both in the general environment and in certain occupations, chemical or physical agents which increase the likelihood of human cancer. Our political response to this would, in an ideal world where sufficient knowledge was available, depend on the direct and indirect costs of the various possible measures of control, and on how many cancers each such measure would prevent. In the real world, estimates of the direct financial costs ofthe control ofparticular agents can easily differ by one or two orders of magnitude, the indirect costs may be grossly exaggerated, or some major indirect costs may be completely overlooked. Worst of all, we have in general no remotely reliable estimates of the numbers of cancers which particular legislative controls would prevent. Consequently, there is wide scope for pressure groups to have considerable influence on public policy. Historically, the most powerful pressure groups in US society have been the large financial interests, which have almost always put financial advantage before human health. Over the past few years the major tobacco companies have launched massive sales drives in the Third World, which if successful will kill millions of people. (About one in four regular cigarette smokers is killed prematurely by smoking.) In the US, where cigarettes cause well over 100,000 deaths every year from lung cancer or chronic obstructive lung disease, the tobacco industry refuses to accept in public that cigarettes cause either disease, let alone to collaborate in serious public information, and no epithet can suitably describe the collective efforts of their advertisers. No other industry kills people on anything like the scale that the tobacco industry does, but where other industries have been found to cause cancer (or dustinduced lung disease) in their workers or in Richard Ptto is a reader in cancer studies at the University of Oxford. This article developed from a review of Samuel Epstein's book. The Politics of Cancer oantMM/itv ianJimi .ao the consumers of their products, their immediate response has usually been to delay acceptance of the findings, to minimise their relevance to current practice, and in general to delay or obstruct any hygienic measures which will cost money. Even when human danger has been unequivocally demonstrated, industrial consortia may- actively lobby for controls so weak that (as with the new UK government regulations limiting inhaled asbestos to 1 fibre/ml from 1981) they leave no reasonable safety margin. Large amounts of money are available to mount press or TV publicity campaigns about the homely apple-pie virtues of asbestos, journals financed by the tobacco industry run populist articles which misrepresent research results to lay readers, and some US television journalists are explicitly told always to censor all reference to the dangers of smoking. Even the scientific literature is not immune from distortion by financial interests. The decades-long argument that "threshold" dose levels of carcinogens must exist below which the general population is absolutely safe has not been entirely motivated by the scientific N plausibility of the hypothesis. With increasing understanding of the derivation of tumours from single cells acted on by mutagenic carcinogens, industry is slowly abandoning "threshold" arguments in favour of arguments1,1 (where the biological fallacies3,4 are somewhat better concealed by the mathematics) that thousandfold reductions in dose can conveniently be "statistically guaranteed" to produce a million-fold or some other enormous reduction in risk. Even if the scientists who propound such models are disinterested, industrial endorsement of them is not. Much excellent toxicology may be done by industry, and many industrial scientists and managers may be directly and honestly concerned with the prevention of hazards. But so many examples of financiallymotivated bias exist that the motives and work of industrial scientists and consultants are inevitably distrusted. Over the past quarter century, the ``environmentalist" camp in North American society has pressed for (and achieved) stricter control of particular carcinogens in the work-place, the general environment, and the diet. Usually, their efforts have been directly resisted by the relevant financial interests. Inevitably, in view of the scantiness of reliable quantitative knowledge about the cancer risks to man of nearly all carcinogens, the argument has polarised. In the politics of cancer, each side takes a very extreme position. Industry usually argues for the irrelevance to man of animal or in vitro cancer tests, or minimisies the quantitative hazards and exaggerates the costs of control. The environmentalists usually exaggerate the likely hazards and are largely indifferent to the cosis of control. `The most powerful pressure groups in the US have been the large financial interests which have almost always put financial advantage before human health' The vacuum of reliable scientific know ledge is such that each side can find scientists who will maintain in courts, in public hearings or in the scientific literature whatever is politically convenient, and it is important to recognise that scientists on both sides of this debate now have career interests at stake in it. A particularly good example of the biased writings of politically active environmentalists is Samuel Epstein's The Politics of Cancer (Sierra Gub Books, 1978, revised in Anchor Press, 1979). Epstein outlines, for university-educated but not necessarily science-educated readers, his view of our present state of knowledge about prevention of death from cancer. He concludes that the cure rates for the major cancers have not been improving much over recent years, but that we do know enough now about the causes of cancer for the testing and regulation of environmental contaminants to prevent the majority of US cancer deaths, and that the main obstacles to our doing so are political rather than scientific. He therefore reviews the scientific and political circumstances surrounding a l990M*mtlUn Journal* Ltd 29* Nature VoL 284 27 March dozen or so disputed consumer products or occupational providing much fascinating political detail, and then describes at length the internal politics of the various agencies which research, regulate and litigate in Washington. have refuted it (see table). This appears to be a deliberate attempt to deceive the reader. It is not a casual slip in a 600-page book, as Epstein devotes twenty pages and two full-page tables to saccharin. His entire table 6.4, entitled ' `Tumours other than the `Scientists on both sides of the environmentalist debate now have career interests at stake' Epstein's book has been written to bladder in rodents fed saccharin'', appears inflame political passions against environmental carcinogens, and parts of it are well worth reading. However, the political punch is often achieved at the to be so subject to artefacts ofselection that it provides no evidence that saccharin does cause any rodent tumours other than in the rat bladder. merely be acting as a vehicle for fat-soluble pesticides and industrial chemicals, which predictably emerge as his villains yet again However, his suggestion is implausible: expense of scientific accuracy and balance. Saccharin is not an isolated example of countries with high levels of contamination Despite this, the book has already gained bias; indeed, I found that in many places do not stand out from the general wide and apparently uncritical acceptance where he discussed data with which I was cancer/fat relationship, colorectal and even among scientists. For thatreason, it is familiar inaccuracies were present, almost breast cancer were common long before the worth considering some of the always in the direction of accentuating the widespread use of pesticides, and in misrepresentations of scientific evidence need for battle with the devils of industry. experimental animals high-fat or low*fat which it contains, and some of the more Turning to more important matters, diets can greatly enhance or reduce the risk general defeca in the environmentalist Epstein asserts that any benefits from the of cancer11. Something more interesting is perspective on cancer. "less dangerous" cigarettes which the waiting to be discovered in our diet than First, a few details. Epstein's book is tobacco industry has developed will be simple contamination by carcinogens. very useful as a source of reference to outweighed by people increasing their The fat-assodated and smoking-derived original papers, but it is not in itself a consumption to get more nicotine, and he cancers collectively account for more than reliable secondary reference because the is therefore in many places particularly half of all cancer deaths, and people material presented is so often distorted. scathing about (or even downright opposed concerned with cancerpolitics should tryto 33 Sometimes this distortion is due to the to) research into changed cigarette understand them considerably more So W effects of Epstein's vigorous campaigning composition. This is a distorted accurately than Epstein appears to. One style on his scientific judgement and is, perspective on one of the more promising can list many other instances where perhaps, forgivable; at other times it immediate means of preventing fatal Epstein's content or style are misleading or 0 CO 0> appears to be deliberate, which cannot so cancers, a quarter of which in America are unbalanced. For example: easily be forgiven. currently due to smoking. The discussion of alcoholism and cancer 01 For example, consider the (by now Smokers of "less dangerous" cigarettes is entirely erroneous because of failure to to generally agreed) finding that incor have already been found in various standardise properly for age. poration of about 5% by weight of epidemiological studies to have disease One of Epstein's chapters ends: saccharin into rat diets gives a few rats rates which are materially lower than "Eisenhower warned against the growing bladder cancer, but has no generally smokers of other cigarettes4*7; at autopsy national threat of the military-industrial accepted effects on any other type of they have far fewer "pre-malignant" complex. The medical-industrial complex cancer. By human standards, 5% repre histological changes in their bronchi4 and, now appears to be as serious a threat". sents a vast saccharin intake (and so, of perhaps due to the changes in cigarette There is idealisation of the value of long course, the industrial ''Calorie Control composition 10 or 20 yean ago male lung term animal tests with concomitant Council" have tried to shrug off these cancer death rates in early middle age are denigration of the value of the Ames test findings). To refute the common reaction now decreasing in North America, in and other short-term tests. This is one of that "anything given in large enough doses Britain and in Finland.__ _ Epstein's most inexplicable errors of will cause cancer in animals", Epstein's After lung, the next"commonest fatal scientific judgement, unless he wants chief argument is to report that 0.01% cancers in the US are those of the breast cancer tests to be difficult and expensive saccharin has also been shown to be and the large intestine, for which the most for industry. carcinogenic. In support of this extra striking epidemiological finding to date is a He is irritatingly puritanical, sneering at ordinary claim, he presents in tabular form 90% correlation between fat consumption "the plastic age which symbolises how the the control and 0.01% data for selected in different countries and their breast or value of our lifestyle has been degraded'*. cancers from certain multi-group feeding colon cancer rates (see figure; similar He seeks by stylistic tricks to attribute to experiments, leaving out the observations correlations exist for colon cancer10). oral contraceptives some of the established from those same experiments which would Epstein suggests that dietary fat may hazards of hormone replacement therapy and of dietbylstilboestrol. Table: Data from OTA report5 on the tumour sites selected for presentation in Epstein's book to substantiate the riaim that 0.01 % saccharin is carcinogenic. Croups selectively omitted in Epstein's book are marked with an asterisk. These omissions substantially alter the implications ofthe original data. He claims that cancer costs the US economy over S23 billion per year. (In fact, cancer must be prevented for humane, not for economic reasons; without cancer,' Saccharin dose (% in rat diet; there would be three or four million more retired North Americans to support, these doses bare Male or female costing over S25 billion per year). no material effect lymphosarcomas Female breast Male breast And so on. He seems so certain about on longevity) (FDA, 1948) (FDA. 1973) (FDA. 1973) - everything -- how can anybody be justified 0 (control) 0.01 0.1 O.f 1 5 0/20 *(0%) 8/14 (57%) 5/16(31%)* 2/13 (13%)* 1/18 (6%)* 10/17 (59%) 6/26 (23%) 14/30 (47%) 13/34 (38%)* 12/30 (40%)* 12/27 (44%)* 6/29(21%) 14/25 (56%) 9/27 (33%)* 8/27 (30%)* 7/25 (28%)* in being so certain about so many details? Sometimes I know he's wrong, but more often (especially in the many places where inconclusive scientific results are presented as established fact) 1 know that nobody knows for sure. Lewis Thomas once wrote, Omitted in Epstein's book. -In addition to these 20, since some other sweeteners were being tested concurrently, 34 other control animals were studied in the same experiment, and the 1977 OTA review of these data, considering ail the control animals to be equivalent, cited 9/54 control lymphosarcomas. (0/10 saccharin controls of each sex were studied, not 0/20 as Epstein inadvertently indicated.) in another context: "The sceptics iij medicine have a hard time of it. It is muc more difficult to be convincing about" ignorance concerning disease mechanisms 0O2J-OM4/IO/ UMUHS01.00 l IttOMaetmlUa JounuisLid Nature VoL 234 27 March 1980 than it is to make claims for full comprehension, especially when the comprehension leads, logically or not, to some sort of action. When it comes to serious illness, the public tends, understandably, to be more sceptical about the sceptics, more willing to believe the true believers." Epstein (like many others) is unjustifiably definite about three major issues. He seems certain that even after the effects of cigarettes have been allowed for, Americans live in an era of rapidly increasing cancer rates. But trends in recorded cancer death rates (and, perhaps more so, recorded incidence rates) over the past quarter century are biased upwards (since the cure rates for the major cancers have not materially improved) by improvements in medical care and cancer counting. These improvements have `The NCI-NEEHS report shows how a group of reasonable men can collectively generate an unreasonable report' affected all sectors of US society, but most particularly old people and previously poor people, especially blacks. Epstein, along with most other US commentators, does not allow for these biases even to the limited extent of restricting his attention to trends in age-specific mortality rates among middle-aged whites, where they might be expected to be least prominent. Among middle-aged whites during the past quarter century, cancer cure rates have not materially improved, but some US cancer mortality trends seem to be genuinely down (stomach, cervix) while some seem to be genuinely up (pancreas, melanoma, and certain lymphomas). I can discern no net pattern other than that due to the massive effects of smoking on lung cancer, although no extension to 1978 yet exists of the excellent 1950-67 trend analyses in NCI monograph 33. In Britain, the same is trueJJ as long as we examine mortality in middle age. (Interestingly, although Epstein emphasises that bladder cancer death rates among whites in the industrial north-eastern US are high, this may not be chiefly due to any current industrial hazard, for they have been decreasing both relatively and absolutely for a quarter of a centurylJ.) Epstein also seems certain that the majority of human cancer is caused by chemical and physical agents in the environment and could be prevented by their testing and regulation. There is no sound scientific basis for this certainty. Since the cancers (lung, breast, large intestine) which are commonest in the US are rare in certain other countries, and vice versa, they probably really are preventable, but (see figure) not necessarily by regulation of any environmental pollutants 0021-0836/80/132M-0301.00 299 or food additives. Indeed, one of the most intriguing animal findings is the effect in many studies of gross aspects of diet on cancer; for example, mice randomised between 5g of food once daily and ad lib consumption averaging 6g/day of the same food, had respectively 8 Vo and 64Vo spontaneous mammary tumours M, and the role of dietary fat" has already been discussed. Thirdly, Epstein seems certain that at least a quarter of all cancer deaths are attributable to occupational exposure to carcinogens. There is as yet no good evidence for hazards of anything like this magnitude, and there is clear evidence that many of his particular claims are exaggerated. For example, he says that asbestos has led to approximately 50,000 deaths per year in the US from cancer and related disease (referencing a paper by Selikoff15 whichactually neithermakes nor implies any such claim). This is sheer nonsense; of 50,000 asbestos deaths, several thousand should be certified as being due to pleural mesothelioma, yet only several hundred per year are thus certified. Likewise, Epstein cites with approval (indeed, he describes it as being of "epochal significance") Health, Education and Welfare Secretary Califano's absurd 1978 estimate, in a speech to labour union leaders, that as many as half of the 8-11 million workers who have been exposed to asbestos could develop serious diseases such as cancer or asbestosis. In his second edition, Epstein draws extensively on Califano's source, a curious but extremelyinfluential document which has been circulating privately for the past year or more. This unpublished typescript, with no listed authors, was prepared by a working group of nine wellknown scientists including Arthur Upton and David Rail, the National Cancer Institute and National Institute of Environmental Health Sciences directors. `Present day cancer rates and trends are probably not dominated by occupational carcinogens or environmental pollutants' both of whom still seem more ready to defend than to repudiate it. Entitled "Estimates of the fraction of cancer in the US related to occupational factors", it shows how a group of reasonable men can coliectiveiy generate an unreasonable report. The group multipiied the 12 million workers exposed in any way in 1972-4 to any of asbestos. As, Ni, Cr, benzene or petrochemicals by the very large risk factors (e.g. fivefold lung cancer excesses) typical of much more extensively exposed industrial populations, finally multiplying again by "4-5" to allow for the additional cancers that will be caused by these six agents among workers exposed to them at times other than 1972-4. (In casual disregard of dosimetry, this whole process is very like predicting 100.000 occupational lung cancer deaths per year among non-smokers due to their exposure to other people's cigarette smoke at work, "since 20Vs of heavy smokers get lung cancer"). These assumptions "predict" over 200.000 extra respiratory tract cancers per year in the near future due to the above six agents alone (and are the sole source of the currently widespread prediction of "20-3 8 V" of cancers being due to occupation). But, in reality, fewer than 90.000 males/year get respiratory tract cancer in the US (and most of these are due to cigarettes and not to occupation at ail), and moreover the US male rates in the first 25 years of working life are currently decreasing! A prediction of 100-200,000 extras due to the above six agents is clearly Figure: data? plotting for 59 countries age-vereus total dietary fat (animal or standardised breast cancer death rate vegetable). 25 r :o 10 Fnak U* CZMiCA* *nw ZEALA/O ^Ltra>rS, ^`TEaonLSANO aec&uM .suSTRfiua S*E5N GESMant 9 HALT X3BWav~ enjutes. C2EO PC*TijGl "L/nGARY *NU1N0 OMj KGNG * PClANC VENEZUELAV* RfiNA/A 'TUG*uCSRUTvOfA*GO JAP4N* *'G3 2.SAuCtfEO-uOyOv ______ L_ 20 40 40 80 1U0 120 Total dietary fat intake (g/day) 140 180 tMOMtoaUUd Jowrtal* Li4 p a s 109660 R&s 109661 300 very unrealistic. The unreality of the whole method is further hiyhifyhfwj by the fact that the assumptions "predict'* 7,300 x 4.3 aided* oxide induced occupational lung cancers/ year. Since nickd refining causes a lot of as well as lung cancer, we would presumably then also soon "expect" something like 13,000 nasal cancer death certificates per year among nickd workers. Nickd has already been widdy used for decades, so many thousands of these should presumably already be evident. In reality," each year in the US population there are only 300-odd male and 200-odd female nasal cancer death certificates. The majority ofthese are not ex-nickd workers and no marked trends are evident. This demonstrates the unsoundness of the NONIEHS methodology. Unfortunately, such exaggerated estimates are so much what many people want to believe ofmodern society thatthey have now achieved a life of their own, and although they are utterly without foundation they are quoted widdy, repeatedly and reputably both in the lay and scientific press. In Geneva the International Labour Organisation reportedly endorsed them, as did the Toxic Substances Strategy Committee in their recent draft report to the US president1*, and they have been used in OSHA to emphasise the need for stricter laws. Most recently, the UK trade union the Association of Scientific, Technical and Managerial Staffs (ASTMS) released a policy document which appears to have been strongly influenced by Epstein's book, and which is notable for its prominent but erroneous assertion, derived solely from the foregoing unpublished US typescript, that 20-40*?* of current UK cancer deaths are caused by occupational carcinogens. Epstein now claims that these exaggerated estimates seriously underestimate the impact of industrial carcinogens. There is obviously a valid political need to exaggerate the importance of the preventive measures we css already `For most toxic chemicals we now have both qualitative and quantitative uncertainty about the health benefits of restriction' implement, but in the long run we do also still need to discover the main preventable causes of cancer other than smoking. Bearing both these needs in mind, there are limits beyond which it is not even politically wise to distort the science of cancer, and some of today's exaggerations may well transgress those limits. Reliable reviews of the known and suspected causes 17,1`-19 of human cancer and of trends in British (XS2M36/K/ IJSOXOSOI - Nature VoL 284 27 March 1980 death rates11 should be more wideiy known. My criticisms of Epstein's science, however, must be viewed in the light of the continued resistance of many industries to reasonable controls. One has only to read some of his descriptions of industrial behaviour to see where his passion comes from, and a suitably sceptical reader could derive much important information from the dozen or so detailed case-histories of particular carcinogens that make up the bulk of this book. But, although I cannot prove it, I suspect that environmentalists as a whole (including Epstein and those US and British trade unions which have already modelled their public statements closely on his book) would be better `The politics of cancer is dominated on both sides by exaggeration' respected and could therefore press more effectively for controls in particular instances if their overview of cancer was more balanced in the following ways: if they accepted that present-day cancer rates and trends are probably not dominated by occupational carcinogens or environmental pollutants (especially since they could still warn that future rates might perhaps be so dominated unless present- day exposures are regulated10}; if their chief concern was with the identification and control of the few major determinants of human cancer (or, in an industrial context, the few major industrial carcinogens) rather than the large multitude ofsins which Epstein denounces; if they discussed the costs and benefits of research into the control of toxic substances in the context of other possible ways of improving longevity (bad diet and tobacco in rich countries, malnutrition and infective and parasitic diseases elsewhere); if they took the costs of imposing restrictions on society more seriously. Epstein's general assertion is that the total direct and indirect costs of failing to regulate usually exceed the real costs of the testing and regulation, but 1 suspect that this is a slogan to avoid political embarrassment rather than a carefully researched conclusion; if they accepted that for most toxic chemicals we have both qualitative and vast quantitative uncertainty about the health benefits of restriction. Particularly, even if the sort of grossly biased interpretation which Eps: a applied to the animal saccharin data is avoided, the results of animal experiments simply are not an uncomplicated key to human hazard identification, moderate alteration of gross aspect:. . diet of animals greatly modifies tneir spontaneous tumour onset rates11 ~ or example, increasing the sugar c -f rat diets may increase their ca.. more than the equivalent amount of dietary saccharin would have done11). Also, any chemical which causes prolifer ation or necrosis in any organ that^L subject to spontaneous cancers is likciw^ft modify the onset rate of tumours in uSr organ, and since the aim of most ?nimai experiments is to study a dose which is nearly, but not quite, sufficient to cause significant weight toss or mortality within three months, it is not surprising that so many chemicals at such doses can cause cancer in animals. However, itmay be that where adversary politics operate one needs views at both extremes in order to get a balanced out come. And there is a possibility that over emphasis on the avoidance of scientific error would emasculate the environmental ist passions and merely lead to sty own rather inactive conservatism. (After all, no scruples about scientific certainty of safety i usually precede the widespread introduc- j tion of new chemicals, so should the j imposition of prudent restrictions require ! absolute proof?) * Environmentalists with biased judge- j meats and a quasireligious certainty of ! right will fight mote battles than any I reasonable sceptic would do, and even if their victories confer 10 or 100 times less benefit on humanity than they imagine, they will in the long run probably do more good than harm -- unless they materially reduce food production, distort researc^^ priorities, or directattention away from tiJft smoking problem in the process. EpsteaB justly quotes, from the 1st century AD, the Plutarch chronicles: "He who in time of faction takes neither side shall be disenfiachised". So, I feel, should both environ mentalists and industrialists who suppress or deliberately misinterpret data, but they probably won't be. For the moment, the 'politics of cancer' is dominated on both tides by exaggeration. t. CorefWd, J. Seim 1W. m (1777). 2. Mantel, N. god SdUKidmUafl, M-A. ConorRt tm* rh 35. 1379(19731. 3. Cntttp. K.5- if oi Cxnrtr Rut* u* J*. 3973 (1976). 4. Gums, W.A. etoiConetr Roorrh 37,3473 (1977), 3. Office of Tedutotocy Assessment of the US Contra* (1977): Conor T*ttin% TeOwOoty out Soofmnn. 6. Hommood, EX. r / in On%utt of Hwmn Conor, Cold Sprint Harbor NY (1977). 7. Wytukt, E.L. <*4/in US pvcranwnc QHEW publication NIH 7f!22J U97), 5. Auerbach, O. gt *i KSniU.Mrd. 309.311 (1979). 9. CiroUt&lC. C*terrrtft*3S, 3374(1973). 10. Ansitront. B.K, and DoU* R. UiuJ.Conetr L5,417(197J), 11. Joi O.O. AWt/i0/i amt Conor 1(3), SI (1979). (Many other ptpm m ail tAr i979 issues ofthu jounui are oftmi fentfai imerat e.i, 1(3) 13. 47 end 27. See Also pun 2 of November 1973 Conor Raorrit devoted wholly to muuuoft end dftcs'l. 12. DoU, R, RrQC.Aor.5QCLon4.tB) 2M, 47 (1979). 13. Blot, WJ.ajKjFrxtHBen, J.F. V..V<f,CiM*erfast 41,1017 (I97S). 14. Roe. FJ.C- and Tucker. MJ. Exetrpt* Medic* (fin. Contras SenesUU. 171 (1974). 13. Seilkotf. (J. id "OnfUis of HumtftOno*'*, Cold Spnst Harbor NY (1977), 16. Norman. A. Soturt 210* 423 (1979), 17. DoU* R..Vetuef 145* 319(1977), It. DolL Jt.VufmionndOmrl(3K23(l979). (9. (ARC wortrnt frouo Cu/tra* ResotnJf *0. 2 (19B0). 20, Davis. D.L. uid Mafee. 9.H. Same*IQ6, |J<4 (1979). l9tOMaomll4d Journals Lid t<rr* !i?STi f r ttf * ( !U * i!i[tn r* M f*N nrm ti)T fniiiir in 1ic m ,n i * ,im irn n v t f fi