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,5VIRONM5T & ,CANC] 

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,PEOPLE 3 

,AU?OR 3 ,MURRAY ,BOOK*9 

,TEXT 3 

,\R ,SYN!TIC ,5VIRONM5T 

  
,MURRAY ,BOOK*9 

  
,*,A,P,T,] ,F,I,V,E3 ,5,V,I,R,O,N,M,5,T ,& ,C,A,N,C,] 

  
,! ,IMPORTANCE ( ,5VIRONM5T 

,ONE ( ! MO/ *ALL5G+ PROBLEMS 9 PUBLIC HEAL? 9VOLVES ! 9FLU5CE ( MAN'S 5VIRONM5T ON ! 9CID5CE ( CANC]4 ,DIFF]5CES ( OP9ION CONC]N+ ! EXT5T ( ?IS 9FLU5CE >E LIKELY TO HAVE IMPORTANT PRACTICAL CONSEQU5CES4 ,IF A SPECIALI/ BELIEVES ?AT CANC] IS CAUS$ PRIM>ILY BY G5ETIC FACTORS OR BY ! AG+ PROCESS1 HIS HOPES = CONTROLL+ ! DISEASE WILL FOCUS ON ADVANCES 9 SURG]Y1 RADIOLOGY1 & *EMICAL !RAPY4 ,HE WILL T5D TO REG>D ! OCCURR5CE ( ! DISEASE AS 9EVITABLE4 ,ON ! O!R H&1 IF HE /RONGLY SUSPECTS ?AT 5VIRONM5TAL FACTORS PLAY A MAJOR ROLE1 HE IS LIKELY TO ATTA* A GREAT DEAL ( IMPORTANCE TO CANC] PREV5TION4 ,HE WILL REG>D 5VIRONM5TAL *ANGE AS A S]I\S PROBLEM REQUIR+ C>EFUL 9VE/IGATION4 ,NO?+ CAN BE DONE TO >RE/ ! AG+ PROCESS OR ALT] ! 9DIVIDUAL'S G5ETIC 5D[M5T1 BUT ALMO/ ANY 5VIRONM5TAL FACTOR ?AT 9FLU5CES ! 9CID5CE ( CANC] IS SUBJECT TO SOME DEGREE ( SOCIAL OR 9DIVIDUAL CONTROL4 ,! MORE EFFECTIVELY CONTROL IS EX]CIS$1 ! L[] ! 9CID5CE ( CANC] IS LIKELY TO BE4 

,TO :AT EXT5T1 !N1 >E ! TWO PO9TS ( VIEW SUPPORT$ BY EVID5CE & SCI5TIFIC AU?ORITY8 

,=TUNATELY1 IT HAS NEV] BE5 E/ABLI%$ ?AT CANC] RESULTS FROM ! AG+ PROCESS4 ,AT MO/ IT HAS BE5 %[N ?AT ! HI<E/ 9CID5CE ( C]TA9 TYPES ( CANC] OCCURS 9 ! LAT] YE>S ( LIFE - A FACT ?AT CAN BE EXPLA9$ BY ! LONG] EXPOSURE ( OLD] PEOPLE TO CANC]-CAUS+ SUB/ANCES4 0,! S5ESC5CE !ORY DOES NO MORE ?AN P>APHRASE A FACT10 NOTES ,SIGISMUND ,PELL]2 0IT FAILS TO 9DICATE H[ & :]E ! *ANGES >E 9ITIAT$ :I* 5D 9 CANC]40 ,! !ORY ?AT CANC] IS 9H]ITABLE RE/S ON MORE IMPRESSIVE EVID5CE &1 = A TIME1 OCCUPI$ A COMM&+ POSITION 9 CANC] RESE>*4 ,IT HAD ITS GREATE/ FOLL[+ 9 ! #a#i#bS1 :5 ,MAUD ,SLYE MANAG$ TO PRODUCE HI<LY 9BR$ /RA9S ( MICE 9 :I* NE>LY EV]Y SPECIM5 ACQUIR$ A CANC]4 ,EV5 ! TYPE ( CANC] & ! AGE AT :I* IT APPE>$ C\LD BE PR$ICT$ ) REASONABLE & (T5 A/ONI%+ ACCURACY4 ,MISS ,SLYE ADVANC$ ! VIEW ?AT CANC] IS DUE TO A S+LE G5ETIC FACTOR ?AT DET]M9ES NE>LY EV]Y ASPECT ( ! DISEASE - ! TYPE ( CANC]1 ! SITE ON :I* IT >ISES1 & ! AGE AT :I* IT APPE>S4 ,:E!R AN 9DIVIDUAL ACQUIR$ A CANC] OR NOT SEEM$ TO DEP5D ALMO/ 5TIRELY UPON HIS G5ETIC 5D[M5T4 

,BUT ! WORLD IS NOT A G5ETICS LABORATORY 9 :I* 9DIVIDUALS >E MAT$ TO PROVE A PO9T AB\T H]$IT>Y CANC]4 ,=TUNATELY1 EXAMPLES ( H]$IT>Y CANC] 9 MAN >E R>E4 ,AFT] FUR!R RESE>*1 IT BECAME EVID5T ?AT SEEM+LY H]$IT>Y CANC]S 9 C]TA9 HI<LY 9BR$ /RA9S ( MICE DEP5D$ UPON A COMPLEX ( NONG5ETIC FACTORS4 ,9 EXP]IM5TS ) ONE ( ! MO/ 09H]ITABLE0 =MS ( ! DISEASE - BREA/ CANC] 9 ! M\SE - ,BITTN] DEMON/RAT$ 0?AT ! K9D ( MILK GIV5 TO A LITT] ACC\NTS = MORE ?AN ALL H]$IT>Y FACTORS TOGE!R4 ,:E!R A HI< OR L[ PROBABILITY ( SPONTANE\S BREA/ CANC] MAY BE EXPECT$ DEP5DS PRIM>ILY UPON ! MILK 7MO!R V]SUS FO/] MO!R TAK5 FROM A DIFF]5T /RA97 :I* ! NEW BORN M\SE ( A G5ETICALLY PURE /RA9 SUCKS 9 ! FIR/ TW5TY-F\R H\RS AFT] BIR?40 ,BITTN]'S 0MILK FACTOR0 IS N[ BELIEV$ TO BE A VIRUS4 ,CL>5CE ,LITTLE F\ND ?AT ! SUSCEPTIBILITY ( 9BR$ MICE TO C]TA9 TUMOR GRAFTS C\LD NOT BE EXPLA9$ )\T TAK+ AT LEA/ F\RTE5 DIFF]5T G5ES 9TO ACC\NT1 & EV5 !N MANY PROBLEMS >OSE :5 ! TUMORS W]E TRANSPLANT$4 ,AL?\< A PR$ISPOSITION TO CANC] MAY BE 9H]IT$1 IT IS DIFFICULT TO BELIEVE ?AT AN 9DIVIDUAL IS =$OOM$ TO ACQUIRE ! DISEASE BY A G5ETIC FACTOR4 0,ON ! CONTR>Y10 OBS]VES ,*>LES ,OB]L+1 DIRECTOR ( ! ,9/ITUTE ( ,CANC] ,RESE>* 9 ,P>IS1 0CANC]\S H]$ITY IS DISCOV]$ TO BE A MOSAIC ( FACTORS ?AT 9T]V5E 9 ! MO/ V>I$ DOMA9S ( ! ANATOMIC1 PHYSIOLOGICAL1 & IMMUNOLOGICAL CON/ITUTION & COOP]ATE 9 PREP>+ A SOIL ?AT IS FAVORABLE = ! EM]G5CE ( A MALIGNANT NEOPLASM40 

,IT IS TEMPT+ TO ADD ?AT IF ! 0SOIL0 IS PREP>$ BY H]$ITY1 ! 0SE$0 IS PLANT$ BY ! 5VIRONM5T4 ,A PR$ISPOSITION TO CANC] IS NOT AN ABSOLUTE ?AT IS EI!R PRES5T OR ABS5T2 IT IS A MATT] ( DEGREE1 V>Y+ FROM P]SON TO P]SON4 ,IT IS LIKELY TO MANIFE/ ITSELF 9 MALIGNANT TUMORS TO ! EXT5T ?AT 9DIVIDUALS >E EXPOS$ TO C>C9OG5S4 ,! GREAT] ! EXPOSURE1 ! HI<] ! 9CID5CE ( CANC]4 ,9 FACT1 CASES >E KN[N 9 :I* ! ACTIVITY ( A P>TICUL> C>C9OG5 L>GELY DET]M9ES ! RATE ( DEA? FROM CANC]4 ,= EXAMPLE1 ,PELL] F\ND ?AT CANC] ACC\NT$ = #ea P]C5T ( ! DEA?S AMONG ! RADIUM M9]S ( ,JOA*IM/HAL 9 ,CZE*OSLOVAKIA4 ,MORE ?AN HALF ! M9]S 9 ?IS COMMUNITY W]E CONFRONT$ ) ! PROSPECT ( DY+ ( CANC]1 AN APPALL+LY HI< P]C5TAGE4 ,AS CANC] 0NORMALLY0 ACC\NTS = #b P]C5T ( ! ADULT MORTALITY RATE1 ,PELL] REASONS1 APPROXIMATELY #ci P]C5T ( ?OSE :O MI<T NEV] HAVE SUCCUMB$ TO ! DISEASE DI$ ( IT4 ,9 !SE CIRCUM/ANCES1 V>IATIONS 9 9DIVIDUAL PR$ISPOSITIONS TO CANC] >E SO MU* OV]%AD[$ BY ! POT5CY ( A C>C9OG5 7RADON7 ?AT ! 0SE$0 CAN G]M9ATE VIRTUALLY )\T ANY 0SOIL0 PREP>$ BY H]$IT>Y OR CON/ITUTIONAL FACTORS4 

,9DE$1 ONE MAY WELL ASK3 ,:AT IS A 0NORMAL0 CANC] DEA? RATE8 ,IS ! TOLL PR$ET]M9$ BY G5ETIC FACTORS OR WILL RATES V>Y M>K$LY 9 DIFF]5T 5VIRONM5TS8 ,! MO/ RELIABLE EVID5CE AT H& SUGGE/S ?AT ! 9CID5CE ( CANC] & ! NUMB] ( LIVES CLAIM$ BY ! DISEASE V>Y APPRECIABLY FROM ONE K9D1 ( 5VIRONM5T TO ANO!R1 EV5 )9 ! SAME G5]AL REGION4 ,AN EXT5SIVE SURVEY ( CANC] ILLNESS 9 ,I[A DUR+ #a#i#e#a1 = EXAMPLE1 %[$ ?AT ! 9CID5CE ( ! DISEASE WAS PROPORTIONATELY ALMO/ #d P]C5T HI<] 9 URBAN >EAS ( ! /ATE ?AN 9 RURAL >EAS4 ,AL?\< L>GE DIFF]5CES C\LD BE EXPECT$ 9 ! 9CID5CE ( LUNG CANC]1 IT IS NOTEWOR?Y ?AT A HI<] RATE WAS REPORT$ AMONG CITY DWELL]S = ALL =MS ( CANC]4 ,URBAN WOM5 HAD A #be P]C5T HI<] 9CID5CE ( BREA/ CANC] & A #e P]C5T HI<] 9CID5CE ( G5ITAL CANC]4 ,SURPRIS+LY1 URBAN M5 HAD A MU* HI<] 9CID5CE ( SK9 CANC] 7#d#e P]C5T71 DESPITE ! FACT ?AT PEOPLE 9 RURAL >EAS >E EXPOS$ TO GREAT] AM\NTS ( SUNLI<T1 A NATURAL C>C9OG54 ,!SE V>IATIONS C\LD NOT BE ACC\NT$ = BY ANY DIFF]5CES 9 ! QUALITY ( M$ICAL S]VICES OR 9 ACCESS TO HOSPITALS & DOCTORS4 0,RURAL >EAS 9 ,I[A APPE> TO HAVE ACCESS TO ! SAME DEGREE & QUALITY ( M$ICAL C>E ?AT URBAN >EAS HAVE4 ,ALSO1 ! CANC] 9CID5CE RATES = RURAL >EAS 9 METROPOLITAN C\NTIES W]E NO HI<] ?AN = RURAL >EAS 9 REMOTE NON-METROPOLITAN C\NTIES40 

,9 ADDITION1 ! 9CID5CE ( CANC] IS HI<] AMONG C]TA9 9COME GR\PS & OCCUPATIONS4 ,! DISEASE OCCURS MO/ FREQU5TLY 9 ! POORE/ /RATA ( ! METROPOLIS4 ,H>OLD ,F4 ,DORN & ,SIDNEY ,J4 ,CUTL] F\ND ?AT AMONG 0:ITE FEMALES ! 9CID5CE ( CANC] WAS #ad P]C5T ABOVE AV]AGE 9 ! L[E/ 9COME CLASS1 BUT OCCURR$ ) AB\T EQUAL FREQU5CY 9 ! F\R O!R 9COME CLASSES444 ,! MO/ CONSI/5T RELATION%IP IS ! OBS]VATION ( RELATIVELY HI< 9CID5CE AMONG MEMB]S ( ! L[] 9COME CLASSES40 ,AL?\< A FEW =MS ( CANC] %[ A MILD PREF]5CE = ! RI*1 MO/ TYPES APPE> ) ! GREATE/ FREQU5CY AMONG ! URBAN POOR4 ,WORK]S :O >E EXPOS$ TO 9DU/RIAL C>C9OG5S HAVE A HI<] 9CID5CE ( CANC] ?AN CL]KS1 & ?OSE 9 NE>LY ALL MAJOR URBAN OCCUPATIONS HAVE RELATIVELY MORE CASES ( ! DISEASE ?AN DO F>M]S4 

,VIEW$ 9 ?IS P]SPECTIVE1 CANC] SEEMS TO HAVE C]TA9 FEATURES 9 COMMON ) TUB]CULOSIS4 ,AL?\< ! TWO DISEASES >E FUNDAM5TALLY DIFF]5T 9 MANY RESPECTS1 IT IS NOTEWOR?Y ?AT ! 9CID5CE ( BO? CANC] & TUB]CULOSIS 9CREASES ) URBANIZATION4 ,NOR CAN WE OV]LOOK ! FACT ?AT CANC]1 LIKE TUB]CULOSIS1 CLAIMS ! L>GE/ NUMB] ( ITS VICTIMS FROM AMONG ! URBAN POOR4 ,! ORGANS 9 :I* ! DISEASES TAKE ROOT 0>E NOT ONLY DET]M9$ BY ! PROP]TIES ( ! P>TICUL> PA?OG5IC .<DISEASE-CAUS+.> AG5T 9VOLV$1 BUT ALSO BY ! TYPE OR R\TE ( CONTACT ) IT10 OBS]VES ,W4 ,C4 ,HUEP]4 0,! CONDITIONS ( EXPOSURE :I* DECIDE ! DEVELOPM5T ( TUB]CULOSIS ( ! LUNGS & ( ! 9TE/9E - 9HALATION & +E/ION1 RESPECTIVELY - >E FUNDAM5TALLY NO DIFF]5T FROM ?OSE :I* >E RESPONSIBLE = ! DEVELOPM5T ( CANC]S ( ! SK91 BONES1 LUNGS1 ETC41 AFT] EXPOSURE TO RADIOACTIVE MAT]IAL BY SK9 CONTACT1 9HALATION1 +E/ION1 OR P>5T]AL 9TRODUCTION40 

,TUB]CULOSIS BECAME P&EMIC ONLY AFT] MAN'S 5VIRONM5T UND]W5T A RADICAL *ANGE4 ,AL?\< RURAL WORK]S W]E FAMILI> ) HUNG] BE=E ! ,9DU/RIAL ,REVOLUTION1 !Y SELDOM CONTRACT$ TUB]CULOSIS 9 L>GE NUMB]S1 P>TLY BECAUSE !Y LIV$ 9 OP5 SURR\ND+S & 5GAG$ 9 HEAL?FUL WORK4 ,! DISEASE1 WE MAY RECALL1 TURN$ 9TO ! 0:ITE PLAGUE0 :5 M5 W]E CR[D$ 9TO L>GE CITIES & OV]WORK$ 9 DISMAL FACTORIES4 ,IT SPREAD AMONG !M RAPIDLY EV5 ?\<1 9 C]TA9 CASES1 !Y W]E GETT+ MORE TO EAT4 ,TUB]CULOSIS PROMOT+ FACTORS OV]%AD[$ ADVANCES ?AT MI<T WELL HAVE PREV5T$ A HI< 9CID5CE ( 9FECTION4 ,TODAY WE KN[ ?AT CONTROL ( ! DISEASE IS A*IEV$ PRIM>ILY ?R\< SOCIAL ADVANCES1 BETT] SANITATION1 & IMPROVEM5T ( ! /&>D ( LIV+4 

,! SAME ATT5TION TO ALL ! ASPECTS ( \R 5VIRONM5T MAY BE REQUIR$ TO CONTROL CANC]4 ,!RE IS GOOD REASON TO BELIEVE ?AT NE>LY EV]Y?+ ?AT S]I\SLY DI/URBS ! PROP] FUNCTION+ ( ! HUMAN ORGANISM1 P>TICUL>LY MANY ( ! TOXICANTS PRODUC$ BY ! PRES5T-DAY 9DU/RIAL REVOLUTION1 CONTRIBUTES TO ! 9CID5CE ( ! DISEASE4 ,WE %ALL F9D ?AT CANC] IS PROMOT$ BY EMOTIONAL /RESS1 POOR DIET1 & A L>GE V>IETY ( 5VIRONM5TAL POLLUTANTS4 ,:ILE ! DISEASE REMA9S A 0RIDDLE10 TO BORR[ ,OB]L+'S WORD1 IT ?REAT5S TO BECOME ! MAJOR CAUSE ( DEA? 9 ! ,UNIT$ ,/ATES & WE/]N ,EUROPE4 ,9 #aide ONE \T ( EV]Y EI<T ,AM]ICANS WAS EXPECT$ TO DIE ( ! DISEASE2 TODAY ! FIGURE IS ONE \T ( SIX4 ,TW5TY-FIVE P]C5T ( ! POPULATION N[ LIV+ 9 ! ,UNIT$ ,/ATES WILL EV5TUALLY ACQUIRE CANC]1 & APPROXIMATELY #d#e1 NEW CASES ( ! DISEASE >E DISCOV]$ ANNUALLY4 ,SWEEP+ 5VIRONM5TAL *ANGES 9 ! N9ETE5? C5TURY PRODUC$ ! 0:ITE PLAGUE0 - P&EMIC TUB]CULOSIS2 *ANGES 9 ! PRES5T C5TURY SEEM TO HAVE SPAWN$ A 0GRAY PLAGUE0 - P&EMIC CANC]4 

,! COMPLEXITY ( ! DISEASE %\LD NOT BE UND]E/IMAT$4 ,IT IS HI<LY IMPROBABLE ?AT ANY CANC]S >ISE 0SPONTANE\SLY10 ?AT IS1 9 ! ABS5CE ( A C>C9OG54 ,:E!R A C>C9OG5 9ITIATES A S]IES ( *ANGES 9 A CELL OR IS CONT9U\SLY 9VOLV$ 9 !M1 ! BIO*EMICAL REACTIONS ?AT LEAD TO MALIGNANT TUMORS (T5 OCCUR 9 /AGES1 MANY ( :I* >E MANIFE/$ BY ABNORMALITIES 9 PRE-CANC]\S TISSUE4 ,:E!R IT IS 9 ! /OMA*1 ! UT]US1 OR ! PRO/ATE GL&1 0CANC] R>ELY APPE>S AS A BOLT FROM ! BLUE10 ,OB]L+ OBS]VES4 0,ALMO/ ALWAYS IT IS PREC$$ BY NUTRITIONAL DI/URBANCES 9 ! EPI!LIUM ?AT MASQU]ADE UND] V>I\S NAMES BUT ?AT >E1 AFT] ALL1 M]ELY ! EXPRESSION ( AN ABNORMAL REACTIVITY TO C]TA9 9FLU5CES40 

,MANY CANC] SPECIALI/S BELIEVE ?AT ONCE A CELL IS ALT]$ BY A C>C9OG51 ! *ANGE IS IRREV]SIBLE2 ! CELL ACQUIRES AN 0IMPR9T0 & TRANSMITS IT TO ALL ITS DESC5DANTS4 ,:E!R OR NOT A CANC] DEVELOPS DEP5DS UPON MANY FACTORS1 SU* AS ! POT5CY ( ! C>C9OG51 ! EXT5T ( EXPOSURE TO O!R *EMICAL & PHYSICAL AG5TS1 & ! 9DIVIDUAL'S CON/ITUTION4 ,MALIGNANT CELLS MAY BECOME DETA*$ FROM A LOCALIZ$ CANC] & 5T] ! BLOOD /REAM )\T PRODUC+ NEW TUMORS4 ,APP>5TLY1 C]TA9 RESI/ANCE ME*ANISMS MU/ BE OV]COME BE=E MALIGNANT CELLS CAN TAKE ROOT ELSE:]E 9 ! BODY & PRODUCE 9VASIVE1 SECOND>Y CANC]S4 

,A CANC] CAN BE 9DUC$ BY A S+LE *EMICAL AG5T OR BY SEV]AL1 BY SMALL1 IRREGUL> DOSES ( ! C>C9OG5 OR BY A FEW L>GE ONES4 ,! DISEASE MAY NOT MANIFE/ ITSELF = MANY YE>S1 EV5 DECADES4 ,A C>C9OG5 MAY REA* MAN BY WAY ( ! AIR HE BREA!S1 ! FLUIDS HE DR9KS1 & ! FOOD HE EATS4 ,IT MAY H>M A SPECIFIC P>T ( ! BODY OR ! ORGANISM AS A :OLE4 ,ANY P[]FUL AG5T OR /IMULUS ?AT ALT]S ! NORMAL FUNCTION+ ( HUMAN METABOLISM OV] A LONG P]IOD ( TIME IS POT5TIALLY C>C9OG5IC4 ,LET US CONC$E ?AT ! WORD 0NORMAL0 HAS YET TO BE DEF9$ & ?AT EA* 9DIVIDUAL HAS DIFF]5T BIOLOGICAL NE$S4 ,BUT LET US ALSO ACKN[L$GE ?AT ! 9CID5CE ( CANC] CAN BE 9CREAS$ 5ORM\SLY BY RECKLESS *ANGES 9 MAN'S 5VIRONM5T1 ?AT MILLIONS ( LIVES >E PLAC$ 9 JEOP>DY BY ?\<TLESS ALT]ATIONS 9 MAN'S MANN] ( LIFE1 DIET1 & PHYSICAL SURR\ND+S4 

,! ,G5]AL ,5VIRONM5T 

,:AT >E SOME ( ! G5]AL1 OR NONSPECIFIC1 FACTORS ?AT 9FLU5CE ! ONSET & PROGRESS ( CANC]8 ,IF ?IS QUE/ION IS (T5 DIFFICULT TO ANSW]1 ! REASON IS NOT ?AT !SE FACTORS >E TOO FEW2 ON ! CONTR>Y1 !RE >E TOO MANY ( !M1 & ! PROBLEM IS TO DECIDE :I* ONES >E ! MO/ IMPORTANT4 ,!RE IS EVID5CE ?AT BO? ! OCCURR5CE ( A CANC] & ITS C\RSE >E 9FLU5C$ BY ! SUBJECT'S EMOTIONAL MAKE-UP1 HIS DIET1 & HIS OCCUPATION4 ,! ADEQUATE TREATM5T ( A CANC]1 9 TURN1 REQUIRES KN[L$GE NOT ONLY ( SURG]Y1 RADIATION1 & *EMICAL !RAPEUTICS BUT ALSO ( ! PATI5T'S *>ACT] & 5VIRONM5T4 ,AL?\< ! C\RSE ( MANY CANC]S IS G5]ALLY PR$ICTABLE1 9DIVIDUAL RESPONSES TO TREATM5T V>Y SO WIDELY ?AT A SPECIFIC CANC] ?AT USUALLY CAUSES DEA? )9 A FEW MON?S CAN1 9 SOME CASES1 BE CONTROLL$ = SEV]AL YE>S4 

,EMOTIONAL /RESS IS AN IMPORTANT ELEM5T 9 ! PROGRESS ( C]TA9 CANC]S4 ,AT ! ANNUAL MEET+ ( ! ,AM]ICAN ,CANC] ,SOCIETY 9 #a#i#e#i1 SEV]AL CANC] SPECIALI/S FOCUS$ ATT5TION ON ! ROLE ?AT ANXIETY SEEMS TO PLAY 9 ! ONSET & C\RSE ( MALIGNANT TUMORS4 ,DRAW+ UPON HIS EXP]I5CES AS A RADIOLOGI/1 ,EUG5E ,P4 ,P5D]GRASS1 ! \TGO+ PRESID5T ( ! SOCIETY1 OBS]V$ ?AT EV5 IF PSY*OLOGICAL FACTORS DO NOT DET]M9E ! EV5TUAL \TCOME ( CANC]1 !Y SEEM TO 9FLU5CE ! DEVELOPM5T ( ! DISEASE4 0,I P]SONALLY HAVE OBS]V$ CANC] PATI5TS :O HAD UND]GONE SUCCESSFUL TREATM5T & W]E LIV+ WELL = YE>S4 ,!N AN EMOTIONAL /RESS SU* AS A DEA? ( A SON 9 ,WORLD ,W> ,I,I1 ! 9FIDELITY ( A DAU<T]-9-LAW1 OR ! BURD5 ( LONG UNEMPLOYM5T SEEMS TO HAVE BE5 A PRECIPITAT+ FACTOR 9 ! REACTIVATION ( !IR DISEASE :I* RESULT$ 9 DEA?40 ,A SIMIL> VIEWPO9T WAS EXPRESS$ BY ,JOHN ,B4 ,GRAHAM1 ( ! ,ROSWELL ,P>K ,MEMORIAL ,9/ITUTE 9 ,BUFFALO4 0,! ADV]SITIES & DESPAIRS ?AT !SE PEOPLE .<CANC] VICTIMS.> >E SUBJECT TO1 & !IR RESPONSES TO !M1 >E 9DE$ FACTORS 9 ! DEVELOPM5T ( CANC] & ! EFFECTIV5ESS ( TREATM5T40 ,AT A PRESS CONF]5CE1 ,GRAHAM ADD$3 0,IT HAS SEEM$ TO US 9 SOME CASES ?AT DESPAIR PREC$ES CANC]4 ,I W\LD NOT SAY IT IS A CAUSE1 BUT IT MAY BE A FACTOR :I* DECIDES :5 CANC] WILL DEVELOP40 

,9 VIEW ( :AT WE KN[ ( ,SELYE'S WORK ON /RESS & ! ADR5AL CORTICOIDS1 !SE CONCLUSIONS %\LD NOT BE SURPRIS+4 ,CORTISONE IS US$ EFFECTIVELY TO DELAY DEA? 9 CASES ( SU* HOPELESS CANC]S AS ACUTE LEUKEMIA4 ,! TEMPOR>Y REMISSIONS A*IEV$ BY ?IS HORMONE >E (T5 /RIK+4 ,AFT] BE+ TREAT$ ) CORTISONE1 A VICTIM ( ACUTE LEUKEMIA (T5 SEEMS TO BE ON ! PO9T ( COMPLETE RECOV]Y1 AL?\< 9 TIME ! CANC] 9V>IABLY OV]COMES ! EFFECTS A*IEV$ BY ! HORMONE4 ,!RE >E REASONS = SUSPECT+ ?AT1 JU/ AS CORTISONE 9HIBITS ! GR[? ( C]TA9 CANC]S1 O!R ADR5AL HORMONES SU/A9 & EV5 PROPAGATE CANC]S ( ! BREA/ & PRO/ATE GL&4 ,BY REMOV+ ! ADR5AL GL&S ( PATI5TS SUFF]+ FROM !SE TUMORS1 PHYSICIANS (T5 GA9 CONTROL ( ! DISEASE = LONG P]IODS ( TIME4 ,NEW ME?ODS >E REPLAC+ ADR5AL SURG]Y1 BUT ! 9HIBITION ( ! PRODUCTION ( CORTICOIDS IS A BASIC TE*NIQUE 9 MANAG+ BO? TYPES ( CANC]4 ,ACCORD+ TO ,SELYE1 ! VALUE ( ADR5AL SURG]Y 9 C]TA9 CASES ( CANC] 0W\LD SUGGE/ ?AT !RE >E ADR5AL FACTORS :I* /IMULATE CANC] =MATION40 

,IT IS TEMPT+ TO SPECULATE :E!R EMOTIONAL /RESS1 BY 9FLU5C+ ! \TPUT ( ! ADR5AL GL&S1 CONTRIBUTES SIGNIFICANTLY TO ! RIS+ 9CID5CE ( CANC]4 ,! ADR5AL CORTEX NORMALLY SECRETES MALE SEX HORMONES 7&ROG5S7 & P]HAPS FEMALE SEX HORMONES 7E/ROG5S74 ,! CORTICOIDS >E ALSO DIRECTLY 9VOLV$ 9 ! SECRETION ( HORMONES BY ! MALE & FEMALE SEX GL&S4 ,MANY EXP]IM5TS HAVE %[N ?AT 9JECTIONS ( E/ROG5S 9DUCE MAMM>Y CANC] 9 CANC]-PRONE MICE1 & 9T5SIVE USE ( E/ROG5 TO CONTROL CANC] ( ! PRO/ATE GL& 9 M5 HAS BE5 FOLL[$1 9 SOME CASES1 BY BREA/ CANC]4 0,!RE CAN BE LITTLE D\BT ?AT 5DOCR9E IMBALANCE IS ! BASIS = *RONIC CY/IC MA/ITIS1 OR MALADIE DE ,RECLUS1 :I* IS *>ACT]IZ$ BY FIBR\S NODULES ?AT >E SOMETIMES 9T]SP]S$ ) CY/S1 & IT HAS BE5 %[N BY ,W>R5 & BY ,FOOTE & ,/EW>T ?AT CANC] IS FIVE TIMES AS COMMON 9 BREA/S AFFECT$ BY ?IS CONDITION AS IT IS 9 NORMAL ONES40 

,OB]L+'S OP9ION1 ADVANC$ 9 #a#i#e#b1 RECEIV$ /RONG SUPPORT SEV]AL YE>S LAT] FROM ! RESULTS ( AUTOPSIES P]=M$ ON #bg WOM5 ) CANC]S ( ! BREA/4 ,! 9VE/IGATORS F\ND EVID5CE ( M>K$ 5DOCR9E IMBALANCES & P>TICUL>LY ( PROLONG$ E/ROG5IC E/ROG5S >E /]OIDS1 & !RE IS A CLOSE RESEMBLANCE BETWE5 ! *EMICAL /RUCTURE ( ! /]OID HORMONES & ?AT ( C]TA9 C>C9OG5S4 ,SOME ( !SE C>C9OG5S1 9 TURN1 HAVE A MILD E/ROG5IC ACTIVITY2 ?AT IS1 !Y PRODUCE1 ON A SMALL] SCALE1 EFFECTS SIMIL> TO ?OSE PRODUC$ BY E/ROG5S & CORTICOIDS4 ,!RE IS A POSSIBILITY EI!R ?AT EXCESSIVE SECRETIONS ( ! /]OIDS TURN PRE-CANC]\S CELLS 9TO CANC]\S ONES OR ?AT ! HORMONES >E ACTUALLY DEGRAD$ 9TO C>C9OG5S4 ,AT ANY RATE1 ! APP>5T RELATION%IPS BETWE5 /RESS & CANC] & BETWE5 ! /]OIDS & C>C9OG5S CAN H>DLY BE IGNOR$4 

0,!RE IS SOLID EVID5CE ?AT ! C\RSE ( DISEASE1 9 G5]AL1 IS AFFECT$ BY EMOTIONAL /RESS10 ,P5D]GRASS OBS]VES4 0,A GR[+ LI/ ( AU?ORITIES HAVE L5T SUPPORT TO ?IS FIELD ( 9VE/IGATION4 ,=EMO/ AMONG !SE IS ,DR4 ,HANS ,SELYE :O DEVOT$ MU* ( HIS LIFE TO ! SUBJECT4 ,9 ORD] TO LE>N AB\T SU* /RESSES1 ONE MU/ EXPLORE BEYOND ! USUAL LIMITS ( A CL9ICAL HI/ORY4 ,?IS TAKES TIME4 ,BUSY DOCTORS MAY BE UNABLE TO GIVE ! TIME TO SECURE A GOOD HI/ORY CONC]N$ ) 5VIRONM5TAL1 CON/ITUTIONAL & O!R FACTORS2 A HI/ORY ( EMOTIONAL /RESS1 OR JU/ ! OPPOSITE2 A CLIMATE ( HAPP9ESS & SECURITY4 ,C\LD ?IS NOT BE AN >EA = ANO!R DISCIPL9E 9 M$IC9E1 .<=.> A SOCIAL SCI5TI/ = 9/ANCE2 OR MAYBE ?IS IS A FIELD :]E ! SOCIAL WORK] %\LD EXP& HIS OR H] ACTIVITIES4 ,I BELIEVE ?AT RESE>* 9 ?IS >EA WILL1 ALMO/ C]TA9LY1 LEAD 9TO 9VE/IGATIONS ( FACTORS ?AT >E SUSCEPTIBLE TO CONTROL HORMONAL SY/EMS & O!R G5]AL METABOLIC 9FLU5CES4 ,?US1 WE AS DOCTORS MAY BEG9 TO EMPHASIZE TREATM5T ( ! PATI5T AS A :OLE1 AS WELL AS ! DISEASE FROM :I* ! PATI5T IS SUFF]+4 ,WE MAY LE>N H[ TO 9FLU5CE ! G5]AL BODY SY/EMS & ?R\< !M MODIFY ! NEOPLASM :I* RESIDES )9 ! BODY40 

,CANC] DOES NOT ALWAYS GR9D 9EXORABLY TO ITS LOGICAL 5D4 ,AT LEA/ #ae SPONTANE\S REMISSIONS ( CANC] 9 MAN HAVE BE5 C>EFULLY AU!NTICAT$ BY REPUTABLE SCI5TI/S4 ,A NUMB] ( !SE TUMORS HAD ALREADY META/ASIZ$ WIDELY & W]E REG>D$ AS 9CURABLE4 ,AS ,OB]L+ OBS]VES3 0444 IT IS DIFFICULT TO E/IMATE ! FREQU5CY ( SPONTANE\S CURE BECAUSE CANC] IS G5]ALLY NOT RECOGNIZ$ UNTIL IT HAS REA*$ AN ADVANC$ /AGE4 ,IT IS 5TIRELY POSSIBLE ?AT MANY MALIGNANT GR[?S DISAPPE> 9 !IR 9ITIAL /AGES1 LEAV+ NO TRACE BEH9D4 ,?IS1 ( C\RSE1 IS ! PURE/ SPECULATION40 

,BUT ,OB]L+'S SPECULATION IS NOT RECKLESS4 ,RESE>* HAS CLE>LY DEMON/RAT$ ?AT ORGANISMS POSSESS ME*ANISMS = RESI/+ CANC]4 ,ACCORD+ TO A REPORT BY ! ,SLOAN-,KETT]+ ,9/ITUTE = ,CANC] ,RESE>*1 DEF5SE ME*ANISMS HAVE BE5 OBS]V$ 9 MICE RECEIV+ TRANSPLANTS ( A HI<LY MALIGNANT CANC] :I* USUALLY KILLS #ie P]C5T ( ITS VICTIMS 9 ?REE WEEKS4 0,IF !SE ANIMALS W]E GIV5 A SMALL DOSE ( MAT]IAL EXTRACT$ FROM YEA/ CELLS CALL$ ZYMOSAN1 !Y DEF5D$ !MSELVES VIGOR\SLY AGA9/ ! CANC]4 ,9/EAD ( KILL+ ! MICE1 ! CANC]S W]E GRADUALLY DISSOLV$ UNTIL !Y DISAPPE>$ 5TIRELY4 ,! ANIMALS W]E !N COMPLETELY CUR$4 ,NO CANC] HAS EV] RETURN$1 & /RONG IMMUNITY TO A SECOND IMPLANTATION HAS BE5 DEMON/RAT$ AS LONG AS #aa MON?S AFT] ! FIR/ GR[? WAS 9ITIAT$4 ,REM>KABLY1 !SE CANC] CELLS GR[N 9 TISSUE CULTURE >E NOT DI/URB$ AT ALL :5 PUT 9 DIRECT CONTACT ) ZYMOSAN4 ,?IS 9DICATES ?AT ZYMOSAN DOES NOT 9HIBIT ! CANC] DIRECTLY BUT ACTS 9 SOME WAY 9 MICE TO 5HANCE !IR NATURAL DEF5SES1 TIPP+ ! SCALES 9 FAVOR ( ! 5DANG]$ HO/ & AGA9/ ! CANC]40 ,! YEA/ EXTRACT1 UN=TUNATELY1 0IS TOO TOXIC 9 MAN = CL9ICAL USE40 

,?IS L9E ( RESE>* IS IMPORTANT BECAUSE HI< RESI/ANCE DEP5DS NOT ONLY ON H]$IT>Y FACTORS BUT ALSO ON GOOD NUTRITION1 A S\ND /ATE ( M9D1 & BALANCE 9 WORK & PLAY4 ,IT IS FAIRLY WELL E/ABLI%$ ?AT ! HI< 9CID5CE ( LIV] CANC]S 9 DEPRESS$ >EAS ( ! WORLD IS DUE 9 L>GE P>T TO DIET>Y DEFICI5CIES ( PROTE9 & POSSIBLY ! ,B VITAM9S4 ,RATS N\RI%$ ON SIMIL>LY DEFICI5T DIETS HAVE A HI< 9CID5CE ( ! DISEASE1 AL?\< IT IS R>E 9 ANIMALS ?AT RECEIVE ! SAME FOOD SUPPLEM5T$ ) :EAT1 YEA/1 OR P[D]$ LIV]4 ,DIET>Y FACTORS MAY ALSO CONTRIBUTE TO ! RELATIVELY HI< 9CID5CE ( *ORIOEPI!LIOMA 7A CANC] ( ! UT]US7 9 ! ,F> ,EA/4 ,9 G5]AL1 H[EV]1 EXP]IM5TAL DATA >E 9CONCLUSIVE = O!R =MS ( CANC] BECAUSE ! RELATION%IP BETWE5 ANIMAL TUMORS & NUTRITION V>IES ) ! /RA9 & SPECIES US$4 0,IT DOES APPE> ?AT MA9T5ANCE ( BODY WEI<T AT A M9IMUM COMPATIBLE ) GOOD HEAL? MAY PREV5T OR DELAY ! DEVELOPM5T ( CANC] 9 MANY 9DIVIDUALS10 OBS]VES ,HEL5 ,N4 ,LOVELL 9 A REVIEW ( ! AVAILABLE EVID5CE4 0,A DIET ADEQUATE 9 ALL NUTRI5TS SEEMS TO BE MO/ DESIRABLE4 ,MANY BELIEVE ! ORAL & PH>YNGEAL SYMPTOMS ( *RONIC RIB(LAV9 & NICOT9IC ACID DEFICI5CY >E PRECANC]\S FACTORS40 

,DESPITE ! 9FLU5CE ( ALL ! FACTORS WE HAVE BE5 DISCUSS+1 MANY WELL-N\RI%$ & S]5E 9DIVIDUALS P]I% FROM VIRUL5T CANC]S FAIRLY E>LY 9 LIFE4 ,:Y8 ,:AT >E SOME ( ! FACTORS ?AT MI<T PRODUCE MALIGNANT TUMORS 9 P]SONS :OSE DIET1 HABITS1 & \TLOOK >E S\ND8 ,!SE QUE/IONS 9TRODUCE A =MIDABLE PROBLEM4 ,MAN IS EXPOS$ TO A L>GE NUMB] ( CANC]-CAUS+ AG5TS2 SOME ( !M >E NATURAL 9 ORIG9 & VIRTUALLY IMPOSSIBLE TO AVOID1 BUT A SUB/ANTIAL NUMB] ( !M >E MAN-MADE4 ,A FEW ( !SE >TIFICIAL AG5TS >E USEFUL 9 M$IC9E1 BUT ! MAJORITY CAN BE EI!R COMPLETELY DISP5S$ ) OR AT LEA/ US$ 9 SU* A WAY ?AT !Y DO NOT AFFECT ! G5]AL PUBLIC4 ,! PRES5CE ( !SE AG5TS 9 ! HUMAN 5VIRONM5T HAS >\S$ A GREAT DEAL ( CONC]N1 & !IR REMOVAL REQUIRES VIGOR\S SOCIAL ACTION4 

,*EMICAL ,C>C9OG5S 

,MAN IS CAPABLE ( PRODUC+ AT LEA/ TWO TYPES ( AG5TS ?AT HAVE CANC]-CAUS+ PROP]TIES4 ,ONE ( !M1 IONIZ+ RADIATION1 WILL BE DISCUSS$ AT SOME L5G? 9 ! FOLL[+ *APT]4 ,\R PR9CIPAL CONC]N H]E WILL BE ) ! *EMICAL C>C9OG5S1 RANG+ FROM CONFIRM$ CANC]-CAUS+ SUB/ANCES TO ?OSE ?AT >E HI<LY SUSPECT4 

,! SUSPICION ?AT *EMICALS 9 MAN'S 5VIRONM5T CAN CAUSE CANC] FIR/ >OSE NE>LY TWO C5TURIES AGO1 :5 ,SIR ,P]CIVAL ,POTT1 A ,LONDON SURGEON1 ID5TIFI$ 0*IMNEY SWEEP'S DISEASE0 AS CANC] ( ! SCROTUM4 ,POTT UN]R+LY PO9T$ TO SOOT1 ! T>RY MAT]IAL =M$ BY ! COMBU/ION ( SOLID FUELS1 AS ! CAUSE ( ?IS MALIGNANT TUMOR4 ,9 ! EI<TE5? C5TURY ! JOB ( CLEAN+ *IMNEYS WAS GIV5 TO BOYS :O W]E SMALL 5\< TO NEGOTIATE ! ELABORATE FLUES 9 ! ,LONDON HOMES ( ?AT P]IOD4 ,AS ! BOYS WORK$1 !IR TR\S]S RUBB$ SOOT 9TO ! SWEAT GL&S ( ! SCROTUM4 ,9 LAT] LIFE1 P]HAPS T5 OR FIFTE5 YE>S AFT] ?IS K9D ( WORK HAD BE5 AB&ON$1 ! SCROTUM W\LD BEG9 TO ULC]ATE & !N DEVELOP A CANC] :I* 9V>IABLY CLAIM$ ! LIFE ( ITS VICTIM4 ,9 #aiad TWO ,JAPANESE 9VE/IGATORS1 ,K4 ,YAMAGIWA & ,K4 ,IT*IKAWA1 SUCCE$$ 9 DEVELOP+ SK9 CANC] 9 #da ( #a< RABBITS :O HAD RECEIV$ APPLICATIONS ( T> TO ! 9T]NAL SURFACE ( ! E>4 ,?REE YE>S LAT] ,H4 ,TSUTSUI WAS ABLE TO SIMIL>LY 9DUCE T> CANC] 9 MICE4 

,! SUCCESS ( !SE ,JAPANESE 9VE/IGATORS MET ) W>M PR(ESSIONAL APPRECIATION - & = GOOD REASON4 ,!IR WORK OP5$ A NEW ]A 9 CANC] RESE>* - ! /UDY ( *EMICAL C>C9OG5S - & ) IT !RE >OSE A HO/ ( DISCONC]T+ PROBLEMS CONC]N+ ! BEHAVIOR ( !SE AG5TS 9 M5 & ANIMALS4 

,YAMAGIWA & ,IT*IKAWA W\LD NOT HAVE BE5 ABLE TO PRODUCE T> CANC] ( ! SK9 IF !Y HAD US$ GU9EA PIGS 9/EAD ( RABBITS4 ,AL?\< T> 9DUCES CANC] 9 MAN1 IT DOES NOT PRODUCE ! DISEASE 9 ! GU9EA PIG1 AN ANIMAL COMMONLY US$ 9 EXP]IM5TAL WORK4 ,9 ALL PROBABILITY1 ! ,JAPANESE 9VE/IGATORS W\LD ALSO HAVE BE5 UNSUCCESSFUL IF !Y HAD US$ RATS4 ,DESPITE REPEAT$ ATTEMPTS FROM #aiad ON1 CANC] ( ! SK9 C\LD NOT BE PRODUC$ 9 ?IS ANIMAL ?R\< APPLICATIONS ( T> UNTIL #a#i#c#e4 ,!Y MI<T ALSO HAVE FAIL$ ) DOGS1 :OSE RESPONSE TO T> IS 0SPORADIC & 9CON/ANT10 9 ,OB]L+'S WORDS4 ,9 %ORT1 EVID5CE ?AT T> IS C>C9OG5IC 9 ANIMALS WAS ACQUIR$ P>TLY ?R\< LUCK & P>TLY ?R\< PATI5CE4 ,YAMAGIWA & ,IT*IKAWA HAD ! GOOD =TUNE TO SELECT AN ANIMAL ?AT IS MORE SUSCEPTIBLE TO T> CANC] ?AN O!R EXP]IM5TAL SUBJECTS1 BUT !Y HAD TO P]SEV]E ?R\< AT LEA/ #ae APPLICATIONS ( ! C>C9OG5 BE=E MALIGNANT TUMORS W]E 9DUC$4 

,!IR EXP]IM5T WAS NOT ! FIR/ ATTEMPT TO 9DUCE CANC] 9 ANIMALS BY MEANS ( T>4 ,SIMIL> EF=TS W]E MADE 9 #a#h#h#h1 #a#h#i1 & #a#h#i#d1 & AGA9 AS LATE AS #a#i#a#c1 BY ,HAGA1 ANO!R ,JAPANESE 9VE/IGATOR4 ,ALL ! ATTEMPTS FAIL$4 ,! EXP]IM5TS 9 ! LA/ TWO DECADES ( ! N9ETE5? C5TURY W]E P]=M$ MO/LY ON DOGS & RATS4 ,HAGA EV5 TURN$ TO ! RABBIT AS A SUBJECT1 BUT HE FAIL$ TO KEEP AT ! T> APPLICATIONS LONG 5\<4 ,! M$ICAL PUNDITS ( ! DAY !REUPON CONCLUD$ ?AT *EMICAL C>C9OG5ESIS DID NOT EXI/4 0,= DECADES !SE FEW NEGATIVE .<EXP]IM5TAL.> RESULTS WEI<$ MORE HEAVILY ?AN NUM]\S OBS]VATIONS TO ! CONTR>Y 9 *IMNEY SWEEPS1 T>1 P>AFF9 & DYE WORK]S1 & MULE SP9N]S10 ,PELL] OBS]VES4 0444 ONLY AFT] POSITIVE EXP]IM5TAL RESULTS ON ANIMALS HAD BE5 PUBLI%$1 DID CANC]OLOGI/S *ANGE !IR OP9IONS4 ,IT WAS =M]LY CONSID]$ SCI5TIFICALLY S\ND TO D5Y ! RELATION%IP2 N[ IT BECAME S\ND TO ACCEPT IT4 ,IF ,YAMAGIWA & ,IT*IKAWA 7#a#i#a#d7 & ,TSUTSUI 7#a#i#a#g7 HAD *OS5 ! RAT = !IR EXP]IM5TS1 9/EAD ( RABBITS & MICE1 !N ! T> G5ESIS ( C]TA9 SK9 EPI!LIOMAS 9 MAN & ! !ORY ( IRRITATION 9 CANC] W\LD HAVE BE5 'EXP]TLY' D5I$ = ANO!R #ag TO #b YE>S1 & ! :OLE DEVELOPM5T ( *EMI/RY ( CANC]OG5S W\LD HAVE BE5 RET>D$40 

,! SAME /ORY CAN BE TOLD AB\T BETA-NAPH?ALAM9E1 A COMP\ND US$ 9 ! PREP>ATION ( A NUMB] ( COAL-T> DYES4 ,BETA-NAPH?ALAM9E1 :I* 9DUCES CANC] ( ! BLADD]1 IS ONE ( ! MO/ POT5T C>C9OG5IC SUB/ANCES 9 MAN'S 5VIRONM5T2 IT HAS CLAIM$ HUNDR$S ( LIVES AMONG WORK]S 9 ! SYN!TIC-DYE 9DU/RY4 ,ATTEMPTS W]E MADE AS E>LY AS #aif TO 9DUCE CANC] 9 RABBITS BY MEANS ( SYN!TIC DYES1 9CLUD+ BETANAPH?ALAM9E1 BUT ! EXP]IM5T]1 ,B4 ,FIS*]1 DID NOT P]SI/ LONG 5\< 9 HIS EF=TS4 ,AFT] PRODUC+ CANC]-LIKE CELLS ?AT REGRESS$ SPONTANE\SLY :5 9JECTIONS ( ! C>C9OG5S W]E /OPP$1 ,FIS*] CONCLUD$ ?AT ! DYES DID NOT 9DUCE OCCUPATIONAL CANC]S4 ,?IS CONCLUSION WAS G5]ALLY ACCEPT$ BY ! M$ICAL PR(ESSION4 ,NOT UNTIL ! LATE #a#i#bS W]E CANC]S PRODUC$ EXP]IM5TALLY BY BETA-NAPH?ALAM9E1 BUT EV5 !N RABBITS PROV$ TO BE POOR SUBJECTS & RATS & MICE W]E F\ND TO BE RESI/ANT TO ! COMP\ND4 ,9 #a#i#c#h1 MORE ?AN ?IRTY YE>S AFT] ,FIS*]'S WORK1 ,HUEP] & HIS C[ORK]S DISCOV]$ ?AT ! ONLY ANIMAL ?AT READILY CONTRACT$ CANC] ( ! BLADD] FROM BETA-NAPH?ALAM9E WAS ! DOG4 

,! REASON = 9FLICT+ !SE DETAILS ON ! READ] %\LD BE FAIRLY OBVI\S4 ,CANC]S 9 ANIMALS 0CANNOT PROVIDE IRREFUTABLE PRO( ( ! SAFETY OR C>C9OG5ICITY ( A SUB/ANCE = ! HUMAN SPECIES10 OBS]VES A REPORT BY ! ,FOOD ,PROTECTION ,COMMITTEE ( ! ,NATIONAL ,ACADEMY ( ,SCI5CES4 ,! COMMITTEE ADDS ?AT 0IT IS P]HAPS REASSUR+ ?AT ! KN[N C>C9OG5IC RESPONSES ( HUMANS TO C]TA9 *EMICALS >E SIMIL> 9 MANY WAYS TO ?OSE SE5 9 EXP]IM5TAL ANIMALS0 - BUT ! QUALIFY+ WORDS 0P]HAPS10 0C]TA910 & 09 MANY WAYS0 C>RY A HEAVY BURD54 ,ACTUALLY1 SOME C>C9OG5S >E H&L$ QUITE DIFF]5TLY 9 MAN FROM ! WAY !Y >E H&L$ 9 COMMON EXP]IM5TAL ANIMALS4 ,BETA-NAPH?ALAM9E1 = EXAMPLE1 IS NOT C>C9OG5IC AS SU*4 ,9 ! HUMAN BODY1 H[EV]1 IT IS METABOLIZ$ 9TO ! C>C9OG5 #b-AM9O-,I-NAPH?OL1 :]EAS RESI/ANT ANIMALS EI!R FAIL TO PRODUCE ?IS METABOLIC COMP\ND OR CREATE IT 9 V]Y SMALL AM\NTS4 

,MANY SUBTLE PHYSIOLOGICAL DIFF]5CES BETWE5 ANIMAL SPECIES - 9DE$1 BETWE5 9DIVIDUALS 9 ! SAME SPECIES - >E LIKELY TO AFFECT ! POT5CY ( A *EMICAL C>C9OG54 0,! ONLY UNIV]SAL C>C9OG5 IS APP>5TLY IONIZ+ RADIATION10 ,HUEP] NOTES4 ,:E!R OR NOT A CANC] IS PRODUC$ BY AN 5VIRONM5TAL C>C9OG5 DEP5DS ON ! ORGAN ) :I* IT COMES 9 CONTACT1 ON ! SOLUBILITY ( ! C>C9OG5 9 ! BODY'S FLUIDS & !RE=E 0ON ! SPE$ ( REMOVAL FROM ! SITE ( PRIM>Y CONTACT ( A C>C9OG51 UPON ! METABOLISM ( ! C>C9OG51 ON ITS R\TE ( EXCRETION & ON ! TISSUE OR ORGAN ( RET5TION OR DEPOSITION ( A C>C9OG54 ,! T>GET ORGAN MAY V>Y 9 DIFF]5T SPECIES40 ,HUEP] CONCLUDES ?AT ! ABILITY ( A C>C9OG5 TO AFFECT DIFF]5T SPECIES & ORGANS 9 DIFF]5T WAYS SEEMS TO DEP5D ON ! DI/9CTIVE METABOLIC PROCESSES ( ! ANIMALS 9VOLV$4 

,!SE FACTORS APP>5TLY ACC\NT = ! FACT ?AT SEV]AL TYPES ( CANC] ?AT >E COMMON 9 MAN >E DIFFICULT TO PRODUCE 9 ANIMALS4 ,= EXAMPLE1 UNTIL V]Y REC5TLY ! MO/ COMMON =M ( /OMA* CANC] 9 HUMANS 7AD5OC>C9OMA7 C\LD NOT BE PRODUC$ 9 RABBITS1 MICE1 RATS1 & DOGS BY FE$+ !M V>I\S C>C9OG5S4 ,ON ! O!R H&1 AD5OC>C9OMAS ( ! SMALL 9TE/9E1 :ILE R>E 9 MAN1 >E FAIRLY EASY TO PRODUCE 9 ANIMALS4 ,! LUNG TUMORS PRODUC$ 9 MICE DO NOT RESEMBLE ! LUNG TUMORS 9 HUMANS ?AT HAVE >\S$ SO MU* PR(ESSIONAL & PUBLIC CONC]N4 ,MANY CANC] SPECIALI/S EV5 DISAGREE ON :E!R !SE TUMORS 9 MICE >E MALIGNANT OR B5IGN4 ,SPONTANE\S REGRESSIONS ( CANC] 9 MICE1 ANIMALS WIDELY US$ 9 CANC] RESE>*1 >E NOT UNCOMMON1 BUT ! REGRESSION ( DIAGNOS$ CANC]S IS V]Y R>E 9 MAN4 

,:5 ! RESE>*] F9DS ?AT A P>TICUL> COMP\ND DOES NOT 9DUCE CANC] 9 RATS1 MICE1 OR DOGS1 HE CAN ONLY HOPE ?AT IT WILL NOT CAUSE ! DISEASE 9 MAN4 ,HE CAN NEV] BE C]TA9 ( ?IS UNLESS C>EFULLY CONTROLL$ EXP]IM5TS ON A L>GE NUMB] ( HUMAN VOLUNTE]S >E CONT9U$ = DECADES )\T CAUS+ A CANC] ?AT IS CLE>LY ATTRIBUTABLE TO ! P>TICUL> *EMICAL4 ,EXP]IM5TS ) ANIMALS >E LIKELY TO BE MORE PA9/AK+ IF ! COMP\ND BE+ TE/$ IS *EMICALLY RELAT$ TO A NUMB] ( KN[N C>C9OG5S4 ,BUT !RE >E NO CLE>-CUT GR\PS ( C>C9OG5IC SUB/ANCES4 ,SOME KN[N C>C9OG5S >E HI<LY COMPLEX HYDROC>BONS2 O!RS1 SU* AS *ROMIUM1 NICKEL1 & >S5IC1 USUALLY REA* MAN AS SIMPLE 9ORGANIC COMP\NDS4 ,(T5 ! MO/ TRIVIAL *EMICAL *ANGE CAN TRANS=M AN APP>5TLY NON-C>C9OG5IC SUB/ANCE 9TO A POT5T C>C9OG54 ,A M]E %IFT ( ! ,N,H#b GR\P 9 ALPHA-NAPH?ALAM9E1 A NON-C>C9OG5IC COMP\ND1 FROM ONE POSITION TO ANO!R 9 ! MOLECUL> R+ ( ! *EMICAL PRODUCES ! C>C9OG5 BETA-NAPH?ALAM9E4 

,MANY C>C9OG5S HAVE BE5 ABLE TO 5T] MAN'S 5VIRONM5T BECAUSE ( ! RELATIVE CRUD5ESS ( EXP]IM5TAL TE*NIQUES4 ,EV5 TODAY1 DESPITE ADVANCES 9 TE/+ ME?ODS1 C>C9OG5IC PROP]TIES >E BE+ DISCOV]$ EV]Y FEW YE>S 9 E/ABLI%$ FOOD ADDITIVES4 ,AT LEA/ T5 *EMICALS LI/$ AS REC5TLY AS #aief BY ! ,NATIONAL ,ACADEMY ( ,SCI5CE 9 ,! ,USE ( ,*EMICAL ,ADDITIVES 9 ,FOOD ,PROCESS+ >E CURR5TLY SUSPECT$ ( BE+ CANC]-CAUS+ AG5TS4 ,!SE 9CLUDE A *EESE PRES]VATIVE 7#h-,HYDROXYQU9ILONE71 A FLAVOR+ AG5T = ROOT BE] 7SAFROLE71 A *EESE /ABILIZ] 7C>BOXYME?YL CELLULOSE71 & SEV]AL COAL-T> DYES4 ,P]HAPS ! WOR/ (F5D]S >E ! DYES1 NOTABLY ,YELL[ ,A,B & ,O,B1 :I* W]E US$ = DECADES TO COLOR BUTT]1 *EESE1 CAKE1 C&Y1 COOKIES1 DRUGS1 & COSMETICS4 ,:5 T5 COMM]CIAL SAMPLES ( !SE FOOD COLORS W]E ANALYZ$ BY ,WALT] ,D4 ,CONWAY & ,ELIZABE? ,J4 ,LE?CO1 ( ! ,NATIONAL ,CANC] ,9/ITUTE1 !Y W]E F\ND TO CONTA9 V]Y L>GE RESIDUES ( BETA-NAPH?ALAM9E1 RANG+ FROM A L[ ( #gf TO A HI< ( #ih P>TS P] MILLION4 

,AL?\< REC5T LEGISLATION /IPULATES ?AT NO C>C9OG5 MAY BE US$ AS A FOOD ADDITIVE1 !RE >E SEV]AL NOTEWOR?Y EXCEPTIONS4 ,LEAD >S5ATE1 = EXAMPLE1 IS /ILL EMPLOY$ AS AN 9SECTICIDE 9 OR*>DS & V9EY>DS4 ,RESIDUES ( ! COMP\ND 7USUALLY #g P>TS P] MILLION7 >E ALL[$ TO REMA9 ON SU* COMMON FRUITS AS APPLES1 PE>S1 PLUMS1 PEA*ES1 *]RIES1 & GRAPES4 '^*,IT HAS BE5 KN[N = MANY YE>S ?AT EXPOSURE TO >S5ICALS PRODUCES A C]TA9 TYPE ( CANC] ( ! SK910 ,FRANCIS ,E4 ,RAY1 DIRECTOR ( ! ,UNIV]SITY ( ,FLORIDA'S ,CANC] ,RESE>* ,LABORATORY1 TOLD ! ,DELANEY ,COMMITTEE4 0,MORE REC5T EVID5CE IS ?AT 9HALATION ( >S5IC DU/ - & SPRAYS - MAY CAUSE CANC] ( ! LUNGS4 ,IT IS POSSIBLE ?AT O!R TYPES ( 9T]NAL CANC] MAY BE CAUS$ BY ! LONG-CONT9U$ +E/ION ( SO-CALL$ NONTOXIC DOSES ( >S5ICALS40 ,RAY DECL>$ ?AT ! USE ( >S5ICALS ON CROPS 0%\LD BE PROHIBIT$40 ,! DEM&1 AL?\< REIT]AT$ BY MANY \T/&+ CANC] SPECIALI/S1 HAS L>GELY BE5 IGNOR$4 

0,:ILE NOT )9 ! SCOPE ( ?IS 9VE/IGATION10 ,RAY ADD$1 0IT MAY BE M5TION$ ?AT FEMALE SEX HORMONES .<E/ROG5S.> HAVE BE5 9CORPORAT$ 9TO COSMETICS4 ,!SE HORMONES HAVE BE5 %[N TO 9DUCE CANC] 9 FEMALE ANIMALS :5 ADM9I/]$ = A PROLONG$ P]IOD4 ,!IR USE 9 COSMETICS %\LD BE PROHIBIT$40 7,! MO/ COMMONLY US$ E/ROG5S 9 FACIAL CREAMS >E E/RADIOL & E/RONE4 ,HUEP] W>NS ?AT AL?\< E/ROG5IC CREAMS >E APPLI$ TO ! SK91 !Y OCCASIONALLY PRODUCE SY/EMIC EFFECTS47 ,?US F>1 H[EV]1 NO ACTION HAS BE5 TAK5 TO =BID ! USE ( E/ROG5S 9 FACIAL CREAMS4 ,9 FACT1 ! USE ( SYN!TIC HORMONES HAS BE5 EXT5D$1 NOT R$UC$4 ,= EXAMPLE1 SYN!TIC HORMONES1 NOTABLY /ILBE/ROL1 >E N[ ADD$ TO #he P]C5T ( ! CATTLE FE$ PRODUC$ 9 ! ,UNIT$ ,/ATES4 ,A WOMAN :O PUR*ASES A COSMETIC ?AT CONTA9S HORMONES EX]CISES A *OICE1 BUT A CONSUM] :O ACQUIRES RESIDUES ( /ILBE/ROL 9 MEAT BELONGS TO A 0CAPTIVE0 POPULATION :OSE WI%ES HAVE NOT BE5 CONSULT$ BY FOOD PRODUC]S OR GOV]NM5T AG5CIES4 ,:E!R ! /ILBE/ROL F$ TO LIVE/OCK MAKES ITS WAY 9TO MEAT HAS BE5 ! SUBJECT ( HEAT$ CONTROV]SY4 ,REGULATIONS PREP>$ BY ! ,F4,D4,A4 /IPULATE ?AT DAILY FE$+S ( ! DRUG %\LD NOT EXCE$ #a MILLIGRAMS = /E]S & #b MILLIGRAMS = %EEP4 ,ACCORD+ TO ! ,F4,D4,A41 RESIDUES ( /ILBE/ROL >E AVOID$ :5 HORMONE-CONTA9+ FE$ IS )DRAWN =TY-EI<T H\RS BE=E SLAU<T]+4 ,ACTUALLY ! EVID5CE = ?IS CLAIM IS EQUIVOCAL4 ,AL?\< ,F4 ,O4 ,GOSSETT & HIS C[ORK]S F\ND ?AT RESIDUES DID NOT APPE> 9 MEAT :5 ! ,F4,D4,A4'S REGULATIONS W]E FOLL[$1 ,C4 ,W4 ,TURN] DETECT$ TRACES ( /ILBE/ROL 9 ! LUNGS & KIDNEYS ( ANIMALS SLAU<T]$ =TY-F\R H\RS AFT] ! PRESCRIB$ #a-MILIGRAM DOSAGES HAD BE5 )DRAWN4 

,EXP]IM5TAL WORK ON MICE BY A GR\P ( RESE>*]S AT ! ,NATIONAL ,CANC] ,9/ITUTE 9DICATES ?AT /ILBE/ROL IS A HI<LY POT5T DRUG4 ,PRACTICALLY ALL ! MICE ?AT HAD RECEIV$ A SUBCUTANE\S IMPLANTATION ( #a MILLIGRAM ( ! SYN!TIC HORMONE ACQUIR$ TUMORS ( ! TE/ICLES )9 SEV5 MON?S4 ,:5 ! PELLET WAS REMOV$ AFT] EI<T WEEKS1 NO GROSS TUMORS DEVELOP$1 BUT :5 IT WAS REIMPLANT$ TW5TY-F\R WEEKS LAT]1 ! 9CID5CE ( TUMORS ROSE %>PLY1 AS ?\< ! PELLET HAD NEV] BE5 REMOV$4 ,! EFFECT ( A BRIEF /IMULUS IS NEV] LO/2 EXPOSURE TO /ILBE/ROL SEEMS TO BE CUMULATIVE4 

,?\S&S ( MAN-MADE *EMICALS ) UNDET]M9$ PROP]TIES 5T] \R FOOD SUPPLY1 WAT]1 & AIR4 ,SOME MAY BE CO-C>C9OG5S2 !SE LACK SIGNIFICANT CANC]-CAUS+ PROP]TIES ( !IR [N BUT 9CREASE ! POT5CY ( KN[N C>C9OG5IC AG5TS4 ,O!RS MAY BE WEAK C>C9OG5S :OSE CANC]-CAUS+ EFFECTS >E ADDITIVE & SYN]GI/IC4 ,ANY SU* C>C9OG5S & COC>C9OG5S W\LD ESCAPE ! ATT5TION ( ! RESE>*] UNLESS !Y W]E BR\<T 9TO COMB9ATION ) ONE ANO!R4 ,BUT ?IS IS A R>E EXP]IM5TAL PROC$URE4 0,POT5TIAL C>C9OG5IC CONTAM9ANTS10 ,HUEP] W>NS1 0ALSO MAY BE 9TRODUC$ 9TO FOOD/UFFS IF VEGETABLES1 FRUITS1 FI%1 OY/]S1 & LIVE/OCK >E GR[N ON SOIL OR 9 WAT] POLLUT$ ) KN[N C>C9OG5S1 SU* AS RADIOACTIVE MATT]1 >S5ICALS1 SEL5IUM & POLYCYCLIC HYDROC>BONS CONTA9$ 9 %IP FUEL OILS1 S9CE !SE *EMICALS MAY BE TAK5 UP & /OR$ BY ! VEGETABLE & ANIMAL MATT] GR[+ 9 SU* CONTAM9AT$ M$IA444 ,!RE EXI/S ALSO ! POSSIBILITY ?AT ORIG9ALLY NONC>C9OG5IC ADDITIVES & CONTAM9ANTS MAY 9T]REACT ) EA* O!R OR ) FOOD CON/ITU5TS & =M NEW COMP\NDS POSSESS+ C>C9OG5IC PROP]TIES 9 ! FOOD/UFFS4 ,!Y MAY BE PRODUC$ UND] ! 9FLU5CE ( PROCESS+ PROC$URES OR DUR+ ! PREP>ATION ( FOOD 9 ! KIT*54 ,PLA/ICS US$ AS WRAPP+ MAT]IAL1 SAUSAGE SK9S & COAT+ MAT]IAL ( FRUITS1 *EESE1 MEAT1 BUTT]1 & CAN L9+S MAY C>RY SIMIL> HAZ>DS40 

,!SE >E NOT IRRESPONSIBLE VAG>IES4 ,A NUMB] ( *LOR9AT$ HYDROC>BONS1 SU* AS ,D,D,T1 SEEM TO HAVE MILD TUMOR-9DUC+ EFFECTS4 ,NE>LY ALL 9SECTICIDES >E DISSOLV$ 9 PETROLEUM DI/ILLATES1 MANY ( :I* >E ALSO SUSPECT$ ( BE+ C>C9OG5S4 ,CRUDE & SEMI REF9$ P>AFF9 WAXES1 FROM :I* COSMETICS & FOOD CONTA9]S >E MADE1 HAVE C>C9OG5IC PROP]TIES &1 9 SOME CASES1 CONTA9 RESIDUES ( HI<LY POT5T CANC]-CAUS+ SUB/ANCES4 ,HANS ,L4 ,FALK1 ,PAUL ,KOT91 & ,ADELE ,MILL] F\ND ?AT ! PROTE9 9 ORD9>Y MILK C\LD ELUATE1 OR EXTRACT1 HYDROC>BONS FROM ! WAX COAT+ ( !IR CONTA9]S4 ,! 9VE/IGATORS HAD DELIB]ATELY IMPREGNAT$ ! WAX ) !SE HYDROC>BONS SO ?AT ! ELUANT PROP]TIES ( MILK C\LD BE TE/$4 0,H[EV]10 !Y WRITE1 0AN ANALYSIS ( SEV]AL DAIRY WAXES REVEAL$ ! PRES5CE ( A SMALL AM\NT ( #a1#b1#e1#f-DIB5ZAN?RAC5E ( ! ORD] ( ONE P>T P] MILLION40 ,DIB5ZAN?RAC5E1 A HI<LY POT5T C>C9OG51 APPE>S AS AN IMPURITY 9 MANY SEMI-REF9$ P>AFFLNS4 

,IT IS DIFFICULT TO SPECIFY ALL ! POT5TIAL HAZ>DS TO PUBLIC HEAL? ?AT >E CREAT$ BY SATURAT+ MAN'S 5VIRONM5T ) POORLY TE/$1 EXOTIC *EMICALS4 ,MANY CANC]S >E /EAL?Y2 !Y DEVELOP SL[LY & IMP]CEPTIBLY4 ,DECADES MAY PASS BE=E MI/AKES COMMITT$ TODAY F9ALLY BE> !IR MALIGNANT FRUIT2 WE MAY PAY A HEAVY PRICE 9 HUMAN LIFE1 NOT SO MU* AS A RESULT ( BRIEF EXPOSURES TO A FEW POT5T C>C9OG5S AS BECAUSE ( ! EXPOSURE ( MILLIONS ( 9DIVIDUALS TO SMALL QUANTITIES ( 0H>MLESS0 COMP\NDS OV] LONG P]IODS4 ,! POT5T C>C9OG5S 0BY !IR V]Y /R5G? >E ALMO/ SURE TO BE DISCOV]$ CL9ICALLY10 ,KOT9 WRITES4 0,9 ESS5CE1 A /RONG C>C9OG5 ID5TIFIES ITSELF BY ! V]Y CIRCUM/ANCES :I* >\S$ SUSPICION 9 ! FIR/ PLACE4 ,IT IS ASSUR$LY ! LESS POT5T C>C9OG5S ?AT SEEM TO BE MORE IMPORTANT 9 HUMAN CANC]1 & IT IS !SE ?AT PROVIDE ! REAL PROBLEM = EVALUATION40 

,5VIRONM5T & ,LUNG ,CANC] 

,! 9CID5CE ( ONE K9D ( MALIGNANT TUMOR1 LUNG CANC]1 HAS BEGUN TO 9CREASE AT AN APPALL+ RATE4 0,A C5TURY AGO1 ,ROKITANSKY ( ,VI5NA1 ! MO/ EXP]I5C$ PA?OLOGI/ ( HIS TIME1 CONSID]$ LUNG CANC] A R>ITY0 ,PELL] OBS]VES4 0,9 O!R & OLD] BOOKS ) DETAIL$ DESCRIPTIONS ( CANC]1 ! LUNGS >E NOT M5TION$ AT ALL1 :]EAS CANC] ( ! L>YNX & ( ! NOSE >E DISCUSS$4 ,FIFTY YE>S AGO1 9 HOSPITALS1 L>YNX CANC] 9 ! ,UNIT$ ,/ATES WAS #a4#e TIMES AS FREQU5T AS LUNG CANC]4 ,9 #a#i#d#g-#d#h1 #i P]C5T ( ALL FATAL CANC]S1 NAMELY #a#h1#a#d#d1 DEVELOP$ 9 ! RESPIRATORY ORGANS & ONLY #a1#h#g ( !M ORIG9AT$ 9 ! L>YNX4 ,! NUMB] ( RECORD$ LUNG CANC]S IS RIS+ MORE RAPIDLY ?AN ?AT ( ANY O!R SUBGR\P40 

,AL?\< IT C\LD BE CLAIM$ ?AT BE=E ,X RAYS W]E DISCOV]$ MANY LUNG CANC]S W]E MI/AK5 = O!R RESPIRATORY DISORD]S1 ! OP9ION ( AN EXP]I5C$1 CONSCI5TI\S M$ICAL MAN SU* AS ,ROKITANSKY CANNOT BE IGNOR$4 ,IF LUNG CANC] HAD BE5 A COMMON DISEASE A C5TURY AGO1 IT W\LD NOT HAVE BE5 REG>D$ AS A M$ICAL CURIOSITY BY MANY ( ! LEAD+ PA?OLOGI/S ( ! DAY4 ,DUR+ ! LA/ FIVE DECADES ! 9CID5CE ( LUNG CANC] 9CREAS$ AT A />TL+ RATE1 & TODAY ! DISEASE IS V]Y COMMON4 ,9 #aiad SEV5 :ITE ,AM]ICAN MALES P] MILLION DI$ ( LUNG CANC]4 ,BY #a#i#e#f1 ?IS FIGURE HAD REA*$ #bhd A =TYFOLD 9CREASE 9 LESS ?AN HALF A C5TURY4 

,IT IS DIFFICULT TO ATTRIBUTE !SE HI<] FIGURES TO IMPROVEM5TS 9 DIAGNO/IC TE*NIQUE4 ,BY ! #a#i#cS1 ,X RAYS W]E BE+ US$ EXT5SIVELY 9 ! ,UNIT$ ,/ATES & BIOPSIES 9VOLV+ ! MICROSCOPIC ANALYSIS ( CANC]\S TISSUE W]E FREQU5TLY P]=M$4 ,NEV]!LESS1 ! NUMB] ( DEA?S FROM LUNG CANC] AMONG ,AM]ICAN MALES ROSE /EADILY AFT] #aic UNTIL IT HAD 9CREAS$ #e P]C5T BY #a#i#e#a4 ,EV5 MORE CONCLUSIVE EVID5CE AGA9/ ! 0DIAGNO/IC IMPROVEM5T0 >GUM5T IS SUPPLI$ BY DATA FROM ! ,COP5HAG5 ,TUB]CULOSIS ,/ATION 9 ,D5M>K4 0,9 A TUB]CULOSIS REF]RAL S]VICE1 US$ EXT5SIVELY BY LOCAL PHYSICIANS1 :]E DIAGNO/IC /&>DS & PROC$URES 9CLUD+ SY/EMATIC BRON*OSCOPY REMA9$ VIRTUALLY UN*ANG$ BETWE5 #aida & #a#i#e1 ! LUNG-CANC] PREVAL5CE RATE AMONG MALE EXAM9EES 9CREAS$ AT A RATE COMP>ABLE TO ?AT RECORD$ BY ! ,DANI% CANC] REGI/RY = ! TOTAL MALE POPULATION10 ,J]OME ,CORNFIELD & HIS COLLEAGUES OBS]VE 9 AN EXCELL5T REVIEW ( ! LUNG CANC] PROBLEM4 0,?IS CAN BE REG>D$ AS EVID5CE ?AT ! REPORT$ 9CREASE 9 ,DANI% 9CID5CE IS NOT DUE TO DIAGNO/IC *ANGES40 

,IT IS EQUALLY DIFFICULT TO ATTRIBUTE ! RISE 9 ! NUMB] ( CASES ( LUNG CANC] TO ! 9CREAS$ LONGEVITY ( ! POPULATION4 ,:ATEV] MAY BE ! FACTORS ?AT ACC\NT = ! HI< 9CID5CE ( CANC] 9 OLD] PEOPLE1 C>EFUL /UDY HAS %[N1 ,CORNFIELD OBS]VES1 ?AT 0ONLY ONE SIX? ( ! OV]-ALL 9CREASE 9 LUNG-CANC] MORTALITY AMONG MALES 9 ! ,UNIT$ ,/ATES 7FROM #d TO #bd DEA?S P] #a1 MALES BETWE5 #aic & #a#i#e#a7 C\LD BE ATTRIBUT$ TO AN AG+ POPULATION4 ,SIMIL> F9D+S HAVE BE5 PRES5T$ = ,5GL& & ,WALES444 ,ALL[ANCE = 9CREAS$ AV]AGE AGE ( ! POPULATION C\LD ACC\NT = ONLY HALF ?IS RISE 9 LUNG-CANC] MORTALITY1 ) A #b#d-FOLD DIFF]5CE BETWE5 #ai & #a#i#e#c40 

,NOR IS IT A CONV9C+ >GUM5T ?AT ! RISE 9 DEA?S FROM LUNG CANC] IS DUE TO CANC]S ?AT BEG9 9 ONE P>T ( ! BODY & LAT] MIGRATE TO ! LUNGS4 ,AUTOPSIES HAVE PROV$ ?IS TO BE A FALLACY4 ,CORNFIELD & HIS ASSOCIATES REVIEW$ ?IRTE5 S]IES ( SU* AUTOPSIES1 ! FIR/ BEGUN E>LY 9 ! PRES5T C5TURY & ! LA/ COMPLET$ 9 ! #a#i#eS4 ,!SE AUTOPSIES SUPPORT ! CLAIM ?AT MORTALITY FROM PRIM>Y LUNG CANC] HAS 9CREAS$ %>PLY DUR+ ! PA/ FIFTY YE>S4 

,! 9ESCAPABLE CONCLUSION SEEMS TO BE ?AT ! RIS+ 9CID5CE ( LUNG CANC] IS DUE TO REC5T *ANGES 9 MAN'S 5VIRONM5T & MANN] ( LIFE4 ,:AT >E ! *ANGES8 ,! MAJORITY ( ,AM]ICAN BIO/ATI/ICIANS & CANC] SPECIALI/S BELIEVE ?AT CASES ( LUNG CANC] >E MULTIPLY+ BECAUSE ( ! 9CREAS$ CONSUMPTION ( CIG>ETTES1 & !Y HAVE COLLECT$ AN 5ORM\S AM\NT ( /ATI/ICAL EVID5CE TO SUPPORT ?IS BELIEF4 0,TW5TY-TWO444 /UDIES ( SMOK+ 9 RELATION TO LUNG CANC] HAVE N[ BE5 C>RI$ \T 9DEP5D5TLY 9 EI<T DIFF]5T C\NTRIES10 NOTES ,E4 ,C4 ,HAMMOND1 ( ! ,AM]ICAN ,CANC] ,SOCIETY4 0,9 EV]Y ONE ( !SE1 A F> L>G] PROPORTION ( SMOK]S 7P>TICUL>LY HEAVY CIG>ETTE SMOK]S7 WAS F\ND AMONG LUNG CANC] PATI5TS ?AN AMONG PEOPLE )\T ?IS DISEASE4 ,?IS HAS BE5 %[N = BO? M5 & WOM540 ,HAMMOND ADDS ?AT 0SIMIL> /UDIES HAVE %[N AN ASSOCIATION BETWE5 SMOK+ & CANC] ( ! BUCCAL CAVITY1 CANC] ( ! L>YNX1 CANC] ( ! BLADD]1 CORON>Y >T]Y DISEASE 7! MO/ COMMON =M ( HE>T DISEASE71 & ,BU]G]'S DISEASE 7A CIRCULATORY DISEASE ( ! EXTREMITIES740 

,?US F> ! MO/ IMPORTANT ATTEMPT TO CORRELATE ! RIS+ 9CID5CE ( LUNG CANC] ) 9CREAS$ SMOK+ HAS BE5 ! SURVEY MADE UND] ! DIRECTION ( ,E4 ,C4 ,HAMMOND & ,DANIEL ,HORN = ! ,AM]ICAN ,CANC] ,SOCIETY4 ,! SOCIETY MOBILIZ$ #b#b1 VOLUNTE]S AS RESE>*]S1 & ASK$ EA* ( !M TO HAVE AB\T T5 M5 BETWE5 FIFTY & SIXTY-N9E YE>S ( AGE COMPLETE A QUE/IONNAIRE ON !IR SMOK+ HABITS4 ,PRECAUTIONS W]E TAK5 TO QU]Y ONLY 9DIVIDUALS :O W]E NOT S]I\SLY ILL1 :O APP>5TLY W]E NOT SUFF]+ FROM LUNG CANC]1 & ) :OM ! RESE>* VOLUNTE]S 5JOY$ SOME MEASURE ( P]SONAL CONTACT1 SO ?AT ?OR\< FOLL[-UPS C\LD BE MADE4 ,NE>LY #a#i1 ACCEPTABLE QUE/IONNAIRES W]E OBTA9$ DUR+ ! FIR/ HALF ( #aieb ,ALMO/ #a#h#h1 W]E FOLL[$ UP BY ! VOLUNTE]S ?R\< ,OCTOB] #a#i#e#e4 ,A C>EFUL /UDY ( ! DEA? C]TIFICATES ( AB\T #a#b1 M5 :O DI$ DUR+ ! ?REE-YE> P]IOD YIELD$ REM>KABLE RESULTS4 ,COMP>+ SMOK]S ) NONSMOK]S 9 ! SAME AGE GR\PS1 ,HAMMOND & ,HORN F\ND ?AT ! G5]AL DEA? RATE WAS #i P]C5T HI<] = OCCASIONAL SMOK]S1 #ab P]C5T HI<] = PIPE SMOK]S1 & #fh P]C5T HI<] = CIG>ETTE SMOK]S4 ,! DEA? RATE = CIG>ETTE SMOK]S 9CREAS$ PROGRESSIVELY ) ! QUANTITY ( CIG>ETTES SMOK$1 NE>LY D\BL+ ) A RISE 9 CONSUMPTION FROM A HALF PACK TO TWO OR MORE PACKS DAILY4 ,IT WAS F\ND ?AT ! 9CID5CE ( LUNG CANC] AMONG CIG>ETTE SMOK]S WAS ALMO/ TWICE AS HI< AS IT WAS AMONG NONSMOK]S4 ,COMP>+ MOD]ATE SMOK]S 7A HALF PACK DAILY7 & HEAVY SMOK]S 7TWO OR MORE PACKS DAILY7 ) NONSMOK]S1 ,HAMMOND & ,HORN F\ND ?AT ! RATIO ( DEA? FROM LUNG CANC] SO>$ TO #ag TO #a & #f TO #a1 RESPECTIVELY4 

,?OSE :O MA9TA9 ?AT !RE IS NO RELATION%IP BETWE5 LUNG CANC] & SMOK+ HAVE BE5 PLAC$ 9 AN UNT5ABLE POSITION4 ,AT FIR/ IT WAS HELD ?AT !RE WAS NO DIRECT EVID5CE TO IMPLICATE TOBACCO T>S 9 CANC] 9 ANIMALS4 ,?IS CONT5TION WAS %AK5 :5 AT LEA/ SIX DIFF]5T LABORATORIES REPORT$ ?AT SU* T>S 9DUC$ SK9 CANC] 9 MICE4 ,IT WAS !N CLAIM$ ?AT AL?\< TOBACCO T>S MAY CAUSE SK9 CANC] 9 MICE1 IT HAD NOT BE5 %[N ?AT !Y C\LD CAUSE LUNG CANC] 9 MICE1 M51 OR ANY O!R SPECIES ( ANIMAL4 ,?IS >GUM5T IS DIFFICULT TO SU/A91 AT LEA/ AS F> AS M5 >E CONC]N$4 ,9 A COOP]ATIVE PROJECT 9ITIAT$ 9 #ai$ UND] ! DIRECTION ( TWO LEAD+ ,AM]ICAN PA?OLOGI/S1 ,OSC> ,AU]BA* & ,>?UR ,S\T1 ! 5TIRE BREA?+ APP>ATUS WAS SY/EMATICALLY REMOV$ FROM ALL 9DIVIDUALS AUTOPSI$ AT ! ,VET]ANS ,HOSPITAL 9 ,EA/ ,ORANGE1 ,NEW ,J]SEY1 & AT ELEV5 HOSPITALS 9 ,NEW ,YORK ,/ATE4 ,! 9VE/IGATORS W]E ABLE TO OBTA9 RELIABLE HI/ORIES ( SMOK+ ON #db ( ! SUBJECTS1 ALL ( !M :ITE MALES1 #fc ( :OM HAD DI$ ( LUNG CANC]4 ,AFT] PREP>+ NE>LY #b1 USABLE SLIDES ( LUNG TISSUE FROM ! #db SUBJECTS & C>EFULLY EXAM9+ EA* SLIDE UND] ! MICROSCOPE1 ! PA?OLOGI/S F\ND ?AT TISSUE ABNORMALITIES 7*ANGES 9 ! EPI!LIUM7 APPE>$ 9 ONLY #a#f4#h P]C5T ( ! SLIDES FROM NONSMOK]S1 9 #i#b4#c P]C5T ( ?OSE FROM LI<T SMOK]S1 9 #i#g4#d P]C5T ( ?OSE FROM MOD]ATE SMOK]S 7A HALF PACK TO A PACK DAILY71 & 9 NE>LY #a P]C5T ( ! SLIDES FROM ?OSE :O SMOK$ MORE ?AN A PACK DAILY4 ,! *ANGES 9 ! LUNG TISSUE FROM ATYPICAL1 POT5TIALLY CANC]\S CELLS TO 9VASIVE1 CANC]\S CELLS 9CREAS$ ) ! AV]AGE 9TAKE ( CIG>ETTES4 ,FOCUS+ !IR ATT5TION ON ALL ! SUBJECTS :O HAD DI$ FROM CAUSES O!R ?AN LUNG CANC]1 ,AU]BA* & ,S\T F\ND ?AT #b#b4#f P]C5T ( ! SLIDES FROM HEAVY SMOK]S HAD ATYPICAL CELLS & #a#a4#d P]C5T HAD CANC]\S CELLS4 ,ON ! O!R H&1 ONLY 4#b P]C5T ( ! SLIDES FROM NONSMOK]S HAD ATYPICAL CELLS & NONE HAD CANC]\S CELLS4 

,H[EV]1 DIS9T]E/$ CRITICS ( ! !ORY ?AT SMOK+ & LUNG CANC] >E RELAT$ HAVE P]=M$ A V]Y USEFUL FUNCTION4 ,BY LOOK+ = O!R FACTORS BESIDES SMOK+1 !Y HAVE DRAWN A GREAT DEAL ( ATT5TION TO ! ROLE ?AT AIR POLLUTION PLAYS 9 PRODUC+ ! DISEASE4 ,! RELATION%IP BETWE5 AIR POLLUTION & LUNG CANC] HAS L>GELY BE5 IGNOR$ DESPITE EVID5CE ?AT LUNG-CANC] RATES >E HI<] 9 CITIES ?AN !Y >E 9 RURAL >EAS4 ,BUT AS MORE RESE>* IS DONE1 ZEALOTS ON BO? SIDES 9 ! LUNG-CANC] CONTROV]SY >E MOV+ T[>D A MORE BALANC$ POSITION4 ,AN IMPRESSIVE AM\NT ( /ATI/ICAL EVID5CE IMPLICATES AIR POLLUTION AS WELL AS SMOK+ 9 ! RIS+ 9CID5CE ( LUNG CANC]4 ,:ITE ,S\? ,AFRICAN MALES1 = EXAMPLE1 >E PROBABLY ! HEAVIE/ SMOK]S ( PACKAG$ CIG>ETTES 9 ! WORLD1 & ! NUMB] ( DEA?S FROM LUNG CANC] AMONG !M HAS 9CREAS$ FROM #a#a4#g P] #a1 9 #aidg TO #b#d4#f 9 #a#i#e#f4 ,BUT ,S\? ,AFRICA PRES5TS AN 9T]E/+ OPPORTUNITY = /ATI/ICAL RESE>*4 ,! C\NTRY HAS ACQUIR$ A L>GE NUMB] ( ,BRITI% IMMIGRANTS1 MO/ ( :OM CAME FROM ,5GLI% CITIES ) HEAVILY POLLUT$ AIR4 ,IS ! 9CID5CE ( LUNG CANC] HI<] AMONG ,BRITI% IMMIGRANTS ?AN AMONG NATIVE-BORN ,S\? ,AFRICANS8 ,AFT] A C>EFUL /ATI/ICAL /UDY1 ,GE(FREY ,DEAN1 ( ! ,PROV9CIAL ,HOSPITAL 9 ,PORT ,ELIZABE?1 ,S\? ,AFRICA1 E/ABLI%$ ?AT 9 ! =TY-FIVE-TO-SIXTY-F\R AGE GR\P1 DEA?S FROM LUNG CANC] W]E #dd P]C5T HI<] AMONG A GR\P ( ,BRITI% MALE IMMIGRANTS ?AN AMONG NATIVE-BORN MALES4 ,! 9CID5CE ( ! DISEASE ROSE ) ! AGE AT :I* IMMIGRATION OCCURR$1 9DICAT+ ?AT LONG] RESID5CE 9 ,5GL& 9CREAS$ ! POSSIBILITY ( DY+ FROM LUNG CANC]4 ,! DIFF]5CE 9 ! DEA? RATE BETWE5 NATIVE-BORN & ,BRITI%-BORN MALES C\LD NOT BE EXPLA9$ BY DIFF]5CES 9 CIG>ETTE BR&S2 ! TWO GR\PS SMOK$ V]Y MU* ! SAME BR&S4 ,BUT ,DEAN'S DATA 9 NO WAY 9DICATE ?AT PROLONG$ SMOK+ IS NOT HAZ>D\S4 ,ON ! CONTR>Y1 ! /EADILY RIS+ RATE ( DEA? FROM LUNG CANC] OBS]V$ 9 BO? GR\PS ( MALES SUPPORTS ! CONT5TION ?AT CIG>ETTE CONSUMPTION PLAYS A MAJOR ROLE 9 CAUS+ ! DISEASE4 

,! AIR OV] ! METROPOLITAN DI/RICTS ( ! ,UNIT$ ,/ATES & ,EUROPE CONTA9S A L>GE V>IETY ( KN[N C>C9OG5S4 ,P]HAPS ! MO/ POT5T ( !SE AG5TS >E ! SO-CALL$ POLYCYCLIC HYDROC>BONS1 SU* AS B5ZPYR5E & AN?RAC5E4 ,BY PA9T+ ! SK9 ( MICE ) B5ZPYR5E ?REE TIMES WEEKLY = SIX MON?S1 ,E4 ,L4 ,WYND] & HIS C[ORK]S W]E ABLE TO PRODUCE CANC]S 9 NE>LY HALF ! ANIMALS4 ,AN 9DIVIDUAL :O SMOKES A PACK ( CIG>ETTES A DAY ACQUIRES AB\T #f MICROGRAMS 7MILLION?S ( A GRAM7 ( B5ZPYR5E A YE>4 ,IF HE LIVES 9 ,HEL5A1 ,MONTANA1 HE 9HALES 4#h MICROGRAMS ( B5ZPYR5E FROM ! AIR ANNUALLY2 9 ,LOS ,ANGELES1 HE 9HALES #b2 9 ,DETROIT1 #a#a2 & 9 ,LONDON1 #c#b4 ,?AT IS1 HE ACQUIRES ! EQUIVAL5T ( ! B5ZPYR5E 9 A ?IRD ( A PACK ( CIG>ETTES DAILY M]ELY BY BREA?+ ! AIR 9 ,LOS ,ANGELES1 ! B5ZPYR5E 9 NE>LY TWO PACKS FROM ! AIR 9 ,DETROIT1 & ! B5ZPYR5E 9 FIVE PACKS FROM ! AIR 9 ,LONDON4 ,IT %\LD NOT BE SURPRIS+ TO LE>N ?AT DEA? RATES = LUNG CANC] AMONG MALES 9 ,5GL& >E MORE ?AN TWICE ?OSE 9 ! ,UNIT$ ,/ATES4 

,KOT9 F\ND ?AT :5 AN EFFICI5T AUTOMOBILE 5G9E REVOLVES #e TIMES P] M9UTE = ONE M9UTE1 IT PRODUCES A GASOL9E EXHAU/ CONTA9+ #bce MICROGRAMS ( B5ZPYR5E4 ,:5 ! 5G9E IS ACCEL]AT$ TO #ce REVOLUTIONS P] M9UTE1 ! AM\NT ( B5ZPYR5E 9 ! EXHAU/ DECREASES TO #a MICROGRAMS4 ,A CONGE/$ ?OR\<F>E CLUTT]$ ) IDL+ OR SL[-MOV+ MOTOR VEHICLES IS A HAZ>D TO HUMAN LUNGS4 ,9DIVIDUALS :O SP5D A L>GE P>T ( !IR TIME 9 SU* >EAS1 IRRESPECTIVE ( ! P>TICUL> METROPOLIS 9 :I* !Y LIVE1 >E LIKELY TO ACQUIRE A LIFETIME DOSAGE ( B5ZPYR5E ?AT IS ?\S&S ( TIMES GREAT] ?AN ! AM\NT REQUIR$ TO PRODUCE CANC] 9 MICE4 

,9 ADDITION TO SMOK+ & AIR POLLUTION1 SOCIOECONOMIC FACTORS HAVE BE5 F\ND TO PLAY A ROLE 9 ! 9CID5CE ( LUNG CANC]4 ,IT IS A TEMPT+ HYPO!SIS ?AT SUSCEPTIBILITY TO ! DISEASE IS 9CREAS$ BY POOR NUTRITION1 ECONOMIC 9SECURITY1 & L[ PHYSICAL RESI/ANCE4 0,! EXI/5CE ( O!R IMPORTANT LUNG-CANC] EFFECTS ASSOCIAT$ ) SU* *>ACT]I/ICS AS SOCIOECONOMIC CLASS CANNOT BE QUE/ION$10 ,CORNFIELD & HIS C[ORK]S /ATE4 0,COH>T F\ND ?AT ! POORE/ ECONOMIC CLASS HAD A #d P]C5T HI<] LUNG-CANC] 9CID5CE ?AN ! REMA9+ POPULATION ( ,NEW ,HAV51 ,CONNECTICUT4 ,RESULTS ( ! #a-CITY MORBIDITY SURVEY .<BY ,DORN & ,CUTL].> HAVE REVEAL$ A %>P GRADI5T 9 LUNG-CANC] 9CID5CE1 BY 9COME CLASS1 = :ITE MALES1 :I* IS CONSI/5T ) ,COH>T'S F9D+S4 ,S9CE CIG>ETTE SMOK+ IS NOT 9V]SELY RELAT$ TO SOCIOECONOMIC /ATUS1 WE CAN AGREE ) ,COH>T '444 ?AT IMPORTANT 5VIRONM5TAL FACTORS O!R ?AN CIG>ETTE SMOK+ EXI/ ?AT CONTRIBUTE TO ! CAUSATION ( LUNG CANC]4' !SE & O!R F9D+S >E CONV9C+ EVID5CE = MULTIPLE CAUSES ( LUNG CANC]4 ,IT IS OBVI\SLY UNT5ABLE TO REG>D SMOK+ ( TOBACCO AS ! SOLE CAUSE ( LUNG CANC]40 7,?IS CONCLUSION IS APP>5TLY %>$ BY ,HAMMOND & ,WYND]1 :O NOT ONLY W]E COAU?ORS ( ,CORNFIELD'S REPORT BUT ALSO PLAY$ AN \T/&+ ROLE 9 FOCUS+ PUBLIC ATT5TION ON ! HAZ>DS ( CIG>ETTE SMOK+47 

,:AT CAN WE LE>N FROM !SE /UDIES8 ,!RE NO LONG] SEEMS TO BE ANY D\BT ?AT ! RIS+ 9CID5CE ( LUNG CANC] IS DUE TO REC5T *ANGES 9 \R SYN!TIC 5VIRONM5T4 ,SO COMPELL+ >E ! DATA N[ AT H& ?AT VIRTUALLY ! 5TIRE SCI5TIFIC COMMUNITY HAS BE5 OBLIG$ TO ACCEPT ?IS CONCLUSION4 ,ONE CAN ONLY WOND] :Y IT WAS NOT ACCEPT$ E>LI]4 ,! GR[+ 9CID5CE ( LUNG CANC] WAS NOT$ AS E>LY AS #aibi 9 ! ,G]MAN ,J\RNAL = ,CANC] ,RESE>* BY ,FRITZ ,LICK9T1 :O ?\<T ?AT ! DISEASE WAS RELAT$ TO SMOK+4 ,9 #aicb ! SAME RELATION%IP WAS EXPLOR$ BY ,W4 ,D4 ,MC,NALLY 9 ! ,AM]ICAN ,J\RNAL ( ,CANC] ,RESE>*4 ,LICK9T & ,MC,NALLY W]E FOLL[$ BY O!R 9VE/IGATORS1 9CLUD+ ,ALTON ,O*SN]1 :O WROTE ON ! SUBJECT 9 #a#i#d#a1 BUT ! SCI5TIFIC COMMUNITY REMA9$ L>GELY UNMOV$4 ,MORE ?AN A DECADE PASS$ BE=E ,HAMMOND & ,HORN F9ALLY PRES5T$ ! PROBLEM ( ! RELATION%IP BETWE5 LUNG CANC] & SMOK+ 9 A =M ?AT WAS TOO COMPELL+ TO BE IGNOR$4 ,UNTIL !N1 ! RISE 9 ! NUMB] ( CASES ( LUNG CANC] WAS G5]ALLY ATTRIBUT$ TO G5ETIC FACTORS OR TO 9CREAS$ LONGEVITY4 

,IT %\LD BE NOT$ ?AT IT HAS TAK5 MANY YE>S = AN OBVI\S L9K BETWE5 5VIRONM5TAL *ANGES & ! RIS+ 9CID5CE ( A MAJOR DISEASE TO GA9 WIDE ACCEPTANCE AMONG SCI5TI/S4 ,BECAUSE ( ITS HI<LY *>G$ SOCIAL1 ECONOMIC1 & POLITICAL IMPLICATIONS1 MAN'S 5VIRONM5T IS AN >5A ?AT SCI5TIFIC RESE>* T5DS TO 5T] ) RELUCTANCE4 ,!RE IS A /RONG DISPOSITION TO PROBE H]$ITY1 A MORE NEUTRAL FIELD1 OR TO DISMISS GRAVE PROBLEMS ( DISEASE AS ! CONSEQU5CE ( GREAT] LONGEVITY4 ,BUT N[ ! EVID5CE ( ! DIRECT CONNECTION BETWE5 ! RIS+ 9CID5CE ( LUNG CANC] & *ANGES 9 MAN'S 5VIRONM5T HAS AFFECT$ ?IS TRADITIONAL APPROA* PR(\NDLY4 ,WE N[ HAVE GOOD REASONS = QUE/ION+ :E!R ANY TYPE ( CANC] NE$ BURD5 MANK9D AS HEAVILY AS IT DOES TODAY4 ,WE HAVE BEGUN TO TAKE A CLOS] LOOK AT ! IRRATIONALITIES 9 \R SYN!TIC 5VIRONM5T4 ,P]HAPS WE %ALL BEG9 TO ELIM9ATE !M4 ,BUT WE CANNOT WAIT 9DEF9ITELY BE=E MAK+ MAN'S 5VIRONM5T & MANN] ( LIFE MORE RATIONAL4 ,MORTALITY FROM CANC] IS RIS+ /EADILY4 ,9 ! ,UNIT$ ,/ATES1 KN[N DEA?S FROM ! DISEASE 9CREAS$ #bb P]C5T BETWE5 #aid & #a#i#e#i1 AN 9CREASE ?AT CAN SC>CELY BE ACC\NT$ = BY ANY MONUM5TAL IMPROVEM5TS 9 DIAGNO/IC TE*NIQUE4 ,REC5TLY A SURVEY ( #fa WOM5 BY ! ,NEW ,YORK ,CITY ,CANC] ,COMMITTEE %[$ ?AT MORE ?AN A ?IRD HAD SYMPTOMS SUGGE/IVE ( MALIGNANT TUMORS OR A PRE-CANC]\S CONDITION4 ,NONE ( ! WOM5 WAS MORE ?AN =TY-TWO YE>S OLD4 ,ROB]T ,A4 ,LOB]FELD1 VISE PRESID5T ( ! COMMITTEE1 IS QUOT$ 9 A NEWS ITEM AS DESCRIB+ ! SITUATION AS 0%OCK+40 ,CANC] HAS EV5 REA*$ EPIDEMIC PROPORTIONS4 ,AT ! ,F\R? ,NATIONAL ,CANC] ,CONF]5CE1 9 ,SEPTEMB] #a#i#f1 ,LE/] ,BRESL[ REPORT$ ?AT 0T5S ( ?\S&S0 ( TR\T 9 WE/]N HAT*]IES SUDD5LY ACQUIR$ LIV] CANC]S4 ,APP>5TLY ! DISEASE WAS 0ASSOCIAT$ ) A NEW TYPE ( DIET10 NOT ) A VIRUS4 

0,TE*NOLOGICAL *ANGES AFFECT+ MAN'S 5VIRONM5T >E BE+ 9TRODUC$ AT SU* A RAPID RATE & ) SO LITTLE CONTROL ?AT IT IS A WOND] MAN HAS ?US F> ESCAP$ ! TYPE ( CANC] EPIDEMIC OCCURR+ ?IS YE> AMONG ! TR\T10 ,BRESL[ TOLD HIS COLLEAGUES4 0,OR HAVE WE8 ,LUNG CANC] IS NOT TOO DISSIMIL> EXCEPT ?AT ! TIME P]IOD IS DECADES1 NOT WEEKS4 ,IF COMMUNITY AIR POLLUTION ( ! TYPES N[ PREVAIL+ OR BE+ 9TRODUC$ BY TE*NOLOGICAL *ANGES IS PROV$ TO BE A CAUSATIVE FACTOR 9 LUNG CANC]1 WE W\LD BE DEAL+ ) EXPOSURE ( MILLIONS ( PEOPLE4 ,NEW POLLUTANTS >E FREQU5TLY ADD$ N[ADAYS TO COMMUNITY AIR ?R\< *ANGES 9 9DU/RIAL PROCESS1 FUEL COMPOSITION & ! LIKE4 ,!Y >E ADD$ = REASONS ( ECONOMY OR EFFICI5CY 9 9DU/RY OR TRANSPORTATION - ESS5TIALLY ! SAME REASONS GIV5 = *ANG+ ! DIET ( ! FI%4 ,IT IS NOT 9CONCEIVABLE ?AT AL?\< CIG>ETTE SMOK+ HAS BE5 ! MAJOR FACTOR 9 ! LUNG CANC] EPIDEMIC DUR+ ! FIR/ HALF ( ! #b? C5TURY1 SOME =M ( COMMUNITY AIR POLLUTION C\LD BE RESPONSIBLE = AN EV5 L>G] EPIDEMIC ( ! DISEASE DUR+ ! SECOND HALF ( ! #b? C5TURY40 

,FROM 3 ,AN>*Y ,>*IVES4 

,*RONOLOGY 3 
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,FEBRU>Y #a1 #bag 3 ,*APT] #e -- ,ADD$4 

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