An Urban's Rural View

Depending on your political persuasion, you may or may not agree with Ronald Reagan that "The nine most terrifying words in the English language are: 'I'm from the government, and I'm here to help.'" You can probably agree, though, that one of the single scariest words in the language is "cancer."

Cancer, to quote the title of a 2010 book (http://tiny.cc/…) and 2015 PBS documentary (http://tiny.cc/…), is "The Emperor of All Maladies." It's the last word anyone wants to hear from a doctor. Once considered tantamount to a death sentence, cancer is still, despite decades of tantalizing progress by medical researchers, far from being "cured." Some 14 million people across the world die of it every year.

Because cure is uncertain, prevention is paramount. If some substance or activity is carcinogenic -- if it causes cancer -- people want to know that. They quite naturally want to avoid things that cause cancer.

Fortunately, there's an international organization that assembles teams of top scientists to identify carcinogens: the International Agency for Research on Cancer (IARC), an affiliate of the World Health Organization (WHO).

Unfortunately, what IARC measures and what the public wants and needs to know are two different things. As a result, the agency's well-publicized and, for the most part, scientifically well-grounded assessments have often been misunderstood.

According to a recent Reuters profile of IARC ((http://tiny.cc/…), the agency has assessed 989 substances or activities over the last four decades. Only one of them -- a component of nylon used in toothbrushes -- received a clean bill of health. The other 988, which include alcohol, red meat, working as a nurse and using a cellphone, were deemed either hazardous or in need of further research.

"Oh, great," you may be tempted to think. "Everything causes cancer." But consider this: In declaring that a substance or activity causes or might cause cancer, IARC isn't answering the man on the street's question, "What is my risk of getting cancer from this?"

The agency isn't saying that at normal exposure levels the substance or activity poses a cancer risk. It's saying that at some exposure level, cancer can or will result. Reuters observes that IARC's top category -- carcinogenic -- makes no distinction between plutonium, which presumably poses a very serious cancer risk, and alcohol, which is presumably less risky. To IARC, they're both carcinogenic, end of story.

The problem is when IARC issues a press release saying something causes cancer, the public hears, "Avoid this." But that isn't necessarily the right conclusion. When IARC last year declared red meat a probable carcinogen, its parent agency, WHO, issued a clarification saying red meat has nutritional value and can be safely consumed in moderation.

Asked by Reuters about the charge that the agency is causing confusion, an IARC official attempted to shift the blame. "There are stakeholders on various sides that want to make it look ridiculous," he said. "There are activist groups who want to say, 'This is now an IARC carcinogen and we need to take all actions against it.' And then there is a third dimension -- the media, who have their own interests in being sensational."

There's undoubtedly something to this. I can't speak for the stakeholders or the activist groups, but the media is indeed part of the problem. Too often news accounts of IARC reports fail to put the agency's findings in context, leaving readers with the impression they are at imminent risk when in many cases they are not.

Sometimes this is not so much about sensationalism or "selling newspapers" as it is a reflection of the nature of news accounts, which of necessity simplify reality. Other times the reporter lacks the training, or the time, to dig in and really understand the agency's news release. But even when the reporter writes the story conscientiously, with all of the necessary qualifications and caveats, the headline writer has little choice but to gloss over the subtleties. There's no space for them in a headline.

Even granting others share the blame, however, IARC is where change needs to start. The agency should announce its findings in a way that doesn't leave the lay audience to guess how seriously if at all it's at risk from a substance or activity. The way it makes its announcements now, IARC is not only misleading the world. It's undermining its own credibility.

(CZ)

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