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PERSPECTIVE ON HEALTH : After 12 Years, Cancer Is Winning : Weakened control of carcinogens heads the list of Reagan/Bush policies that benefited business as the death rate soared.

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<i> Dr. Samuel S. Epstein is professor of environmental and occupational medicine at the University of Illinois School of Public Health. He wrote last February's critique of federal cancer policies</i>

The administrations of George Bush and Ronald Reagan, by pandering to reckless corporate self-interest, scuttled the war against cancer. One of the Clinton Administration’s bigger jobs will be to revive it.

Cancer now strikes one in three Americans and kills one in four. In 1960, the incidence was one in four and deaths were one in five. Over the last decade, 5 million people have died in this cancer epidemic (deaths from the highly politicized AIDS catastrophe number under 300,000). Cancer rates are particularly high among blacks, the urban poor and 11 million workers in petrochemical, metal and nuclear industries--and also among their children. A recent American Hospital Assn. report predicts that cancer will become the leading cause of death by 2000 and medicine’s “dominant specialty.” The costs in suffering, death and lost wages, estimated at $110 billion annually, or nearly 2% of GNP, are key factors in the current health-care crisis. Medicare cancer payments exceed those per case for any other disease.

There is plenty of evidence that the cancer increase is due to progressive permeation of air, water, food and the workplace with cancer-causing industrial chemicals. There is also well-established evidence that a substantial proportion of all cancers is avoidable.

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As chairman of the 1981 Regulatory Relief Task Force, then-Vice President Bush crafted strategies designed to weaken federal regulatory agencies. Key among these was insistence on cost-benefit analysis that focused on industry costs without considering costs of failure to regulate. Fronted by Vice President Quayle’s Council on Competitiveness, a faithful clone of the Bush task force, the Administration moved aggressively to deregulate carcinogenic and toxic substances:

- In 1989, the Administration revoked a ban on deliberate contamination of food with any level of carcinogenic pesticide. The Environmental Protection Agency’s new standard allows “negligible” pesticide residues posing “acceptable” cancer risks. Even by Administration estimates, this is likely to result in tens of thousands of avoidable cancers every year.

- In March, 1992, the White House blocked proposed Occupational Safety and Health Administration standards for more than 500 carcinogenic and toxic air contaminants in agricultural, construction and maritime industries. In a bizarre “wealth is health” theory, the Administration maintains that the proposed standards would damage workers’ health by forcing industry to cut wages and jobs.

- In April, 1992, Rep. Henry Waxman (D-Los Angeles) accused President Bush of gutting the Clean Air Act. Meeting secretly with industry lobbyists, Quayle’s council developed loopholes permitting oil refineries and thousands of other industries to vastly increase emissions of carcinogens and toxic chemicals.

- Recent Administration proposals have included abrogating the regulating authority of federal agencies and allowing industry to dump millions of tons of untreated carcinogenic and toxic wastes in municipal dumps.

Complementing the Administration’s regulatory “relief” is its control of, or at least powerful influence over, federal research. A report last summer by public-interest groups charged that federal researchers, including the Centers for Disease Control, conducted hundreds of deliberately inconclusive studies on the relationship of environmental pollution to cancer and other diseases. Flaws included hiring biased researchers and conducting studies too small to produce significant findings.

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The Administration’s influence extends to the National Cancer Institute, the chief federal agency for cancer research and policy. The White House appoints the director, the three-member executive panel (the late Armand Hammer, CEO of Occidental Petroleum was its last chairman) and the 18-member advisory board. The NCI allocates less than 10% of its $2-billion annual budget to cancer prevention, while misleadingly claiming much higher spending. Environmental pollution and occupational exposures are trivialized as significant causes of cancer.

The institute’s approach to cancer prevention runs the gamut from indifference to hostility. Despite strong opposition from independent cancer experts, the NCI supports destroying the national chemical testing program. Following its establishment in 1978, this unique program tested an annual average of 40 industrial and consumer products. Federal and state regulators paid close attention to chemicals subsequently listed as posing cancer risks. This year, only four new chemicals are being tested. Even this is too much for the Administration--it proposes testing procedures that would all but ensure that no substance, not even asbestos, could be classified as carcinogenic. An industry spokesman who is a former senior NCI official stated: “We have to use an economic test. If it is useful to society, we will not call it a carcinogen.”

A report issued in February by around 70 leading experts in cancer prevention and public health expressed “grave concerns over the failure of the war against cancer” and urged radical reforms.

Given the national toll of cancer, its prevention, unmentioned during the campaign, should rank high among the new President’s priorities. Bill Clinton and Al Gore, with their strong commitment to environmental and health concerns, show promise, especially if they recognize the high economic costs and inflationary impact of cancer.

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