8 weeks before an organization named the Inter-Agency Breast Cancer and Environmental Research Coordinating Committee, or IBCERCC, released a 270-page report entitled updated Cancer and the Environment: Prioritizing Prevention.a The statement was the result of 8 years of lobbying by breast cancer advocates to acquire increased funding for research dedicated to prevention of the disease and the direct results of the Breast Cancer and the Environment Research Act passed by Congress in 2008.A A major force behind the statement was the National Breast Cancer Coalition (NBCC), an active organization which since 1991 has been quite effective to make breast cancer research and treatment a national goal. The 2008 bill called for the formation of the committee to draft a study detailing goals for prevention.A The cell was to consist of representatives from advocacy groups; afederal membersa from agencies including the National Institute of Environmental Health Sciences, the National Cancer Institute, the Environmental Protection Agency, the Department of Defense, and the Centers for Disease Get a grip on and Prevention; and non-federal members from the medical and clinical areas. The report, that has been couple of years in the making, did not lack for ambitious ambitions, among them: ato prioritize prevention,a ato change how research is conducted,a ato strategy purposefully across national agencies,a ato practice trans-disciplinary researchers,a and ato read and communicate science to society.a But the understanding of these high objectives was compromised by the different agendas of the diverse membership of the committee.A Some were advanced members of the advocacy movement who really thought that more could be done to find out new information that would lend itself to prevention.AA Others had a narrow plan to focus on substances in the atmosphere, whether this was highly relevant to breast cancer or not.A Some of the scientists were focused on defending their turf in the place of animal types of breast cancer.AA Finally, the bureaucrats from NIEHS and NCI were developing their particular agendas. At the core of the report is a fatal confusion between two different uses of the word aenvironment.a AAInitially the IBCERCC report defines the environment broadly to include everything that's not genetics a lifestyle and behavioral factors, such as for example alcohol consumption and physical activity; social and cultural influences; and chemical and physical agents that individuals are confronted with, including commercial contaminants, pesticides, an such like. Nevertheless, it becomes obvious early on that the major thrust was to highlight a much narrower definition of aenvironment,a specifically the essential role of contact with substances and their effects on breast tissue beginning in utero and throughout the life course. The confusion between both of these explanations proves useful to authors of the report, because most people don't stop to look at the distinction and do not know the evidence for every alternative.A Therefore the report can blur the distinction between the well-founded broad definition and the poorly-supported but far more amazing slim definition entailing experience of chemical contaminants. To support its philosophy, the report argues that exposure to aendocrine disruptorsa and other kinds of chemicals in food, water, the air, and in cosmetics and cleaning products are likely to be important contributors to breast cancer and need to be the focus of extensive, inter-disciplinary research.A (The term endocrine disruptors describes substances that have hormonal effects in dwelling organisms. )A In doing this, the report embraces studies that appear to support its claim and at the same time ignores much more thorough studies that do not support the existence of a danger. We know a great deal about breast cancer, but nearly all of what is known does not lend itself to prevention.A And so the question is, How well does the assumption that experience of substances in the environmental surroundings play an integral role in breast cancer square with what we know? Breast cancer in the usa is definitely associated with socio-economic status, i.e., with higher educational level and higher income.A In addition it occurs more commonly in Anglo women than in Latinas a' strikingly, the later group having about 30-35 percent lower incidence.A This really is most likely explained by the truth that more educated women and Anglo women are more likely to delay having children, more likely to have fewer children, and more likely to have used hormone therapy after menopause.A Many of these factors are associated with increased risk. On the facial skin of it, exposure to chemicals in the environmental surroundings will probably be LOWER in higher income women a' think about the greater exposure to traffic exhaust in lower income neighborhoods, exposure to chemicals in waste websites, as well as occupational exposures. Now letas consider the data for a role of particular substances in the environment.A The IBCERCC report focuses on BPA as a for the possible contribution of aendocrine disruptorsa in producing breast cancer.A It emphasizes that exposure to BPA is common in the general population as evidenced by the diagnosis of BPA in the urine of 95% of individuals in studies of the general population.A In addition, the report cites effects of BPA on mammary tissue in animal studies. What's striking is these answers are generally from a single group of scientists, at Tufts University, who've an extended history of promoting the idea of endocrine disruption. The statement entirely ignores state-of-the-art studies performed by researchers at the FDA and the National Toxicology Program examining true BPA exposure, metabolism, and excretionA in mice and monkeys in utero and postnatally, as well as a research reviewing major BPA exposure in humans. What these reports show is that: (Over the past few years, Trevor Butterworth has done an exceptional job of exposing the bad research behind the BPA juggernaut and has drawn focus on the work of Daniel Doerge of the FDA and the National Toxicology Program Aand Justin Teeguarden of the Pacific Northwest National Laboratory) These results from scrupulously made reports flatly contradicted the popular claims about experience of BPA and also call in to question a lot of the data regarding endocrine disruptors in general.A However, this work is nowhere mentioned in the IBCERCC record. This points up an over-all issue that also escaped the attention of the IBCERCC panel.A AThat is the issue of afalse positivesa in health studies.A In other words, false positives are originally reported results that gain attention a' often having a massive impact on the community and the press a' which aren't borne out when more demanding and effective studies are done to ensure the original effect. False positives are a tremendous problem.A The statistical methodologist John Ioannidis of Stanford has drawn attention to this problem with a 2005 report entitled aMost Research Findings Are False.a AAnd others have addressed the problem as well.ABut it is something to take note of the problem and quite still another to root it out, since difficult-to-obtain financing and professional growth hinge on researchersa publishing what seem to be fresh and essential findings.A Results that feed the general public concern about hazards in the environmental surroundings thus have a better potential for gaining attention from federal agencies whose mandate it to handle such hazards. In the end, the leadership of the NBCC, which was so instrumental in lobbying for development on prevention of breast cancer, was terribly disappointed by the end-product.A Laura Nikolaides, who's the organizationas director of research and quality care plans and was a of the committee, described NBCCas reaction to me.A After lobbying for 8 years, NBCC had wanted significantly more than aan empty statement that made a panel to publish another are accountable to sit on a shelf.a You'd think that someone on the committee or those managing its work would took issue with the uncritical and wrong-headed emphasis on substances in the environment.A But once created, committees tend to just take on a of their own, and their structure can determine the nature of results reached.A In the end, each of the participating teams a' scientists, government employees, and advocates a had its own times that overrode a reading of the research. In the course of discussing the issue of breast cancer prevention, many colleagues stated that, in one formulation, aThe desire to own some additional exposure to blame for breast cancer is very strong.aA AIt is understandable that advocates a several of them breast cancer survivors a' were influenced by the desire to spot a culprit in the surface world as a cause of breast cancer that might be prevented. What's harder to know is how, from their very different vantage points, scientists and bureaucrats uncritically accepted the reigning dogma regarding aendocrine disruptorsa based on shoddy studies that provided positive results, while supplying short shrift to state-of-the-art studies that offered a very different picture.AA In the end, advocates, scientists, and bureaucrats served as good enablers to advertise a view that pleased their preconceived ideas and personal agendas. Perhaps most shocking and disturbing is the fact that academic researchers and highly-placed officers at NIEHS and NCI could have recommended this uncritical and eventually distracting report.A While showing itself in a self-approving way to be about science, the survey is about something completely different.
No comments:
Post a Comment