Tracking the Rise of an Epidemic

James Morton

CANCER INCIDENCE BEGAN a serious rise sometime between the Second National Cancer Survey (SNCS 1947-50) and the Third National Cancer Survey (TNCS 1969-71). Mortality statistics collected annually indicate an almost flat response between 1950 and 1965, and then begin a continual and accelerating rise.

By 1965 Samuel Epstein, a physician specializing in occupational medicine, began to see evidence that a general cancer epidemic was building, propelled by the petrochemicals ravaging workers in petroleum refineries and in chemical and rubber manufacture By 1979 Epstein had enough data to publish the seminal work in cancer analysis, The Politics of Cancer (Anchor Press/ Doubleday). We now have far better data proving that Epstein was correct.

The most reliable data we have for the overall increase of cancer incidence begins in 1973 with the initiation of the U.S. cancer registry, the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute.

The construction of the SEER registry avoids many of the inconsistencies of lime, diagnostic technique, and geographic area which made it difficult to compare the data on previous national cancer surveys. SEER collects data on cancer incidence and survival rates twice a year from the same hospitals in four urban areas and five states, representing 12% of the U.S. population.

One of the, most common apologies for the epidemic is that incidence is rising mostly because people are not dying as frequently of heart or infectious diseases, thus living long enough to die of cancer.

SEER disposes of this argument in two ways. First the information has been “age adjusted” to the 1970 population distribution so that in 1985 the percentage of elderly sampled is the same as in the 1970 population. Second, SEER gives age-specific incidence rates. Hence in the table “Age-Specific Cancer Incidence Rates in White Males” which excludes lung cancer, the incidence of cancer for white males rises significantly in seven out of eight age categories.

SEER presents cancer incidence as all-site composite figures and by site alone. The more these figures are refined, the more they tell us. For example, SEER withdraws lung cancer from the statistics to give us the second line in the table “Incidence Rate Increase For All Cancer Sites.” Since the working class are the heaviest tobacco users and have the most intense contact with petrochemicals, cigarette smoking tends to obscure a number of petrocancers. There are other studies which suggest that from 3347% of all lung cancer has an occupational aetiology. Nor does cigarette smoking like explain why people living in cities like Detroit and Atlanta have a 50% excess of lung cancer over rural areas.

The incidence of cancer is accelerating among men at almost twice the rate that it is among women, the only significant difference in their environments is found in the workplace, where men are exposed to far more organic compounds. Therefore it is useful for those obscuring the extent and origin of the epidemic to combine male and female rates.

Lung cancer serves ruling-class purpose in the same manner. The standard ploy of the National Cancer Institute and the American Cancer Society has been to publish a combined incidence figure for the first line, then follow with a combination of the second line to say that it’s just people killing themselves with cigarettes. These days that second line shows a grossly understated, but nonetheless alarming, 7.9 % increase.

Look how dramatically the appearance of the epidemic changes among women when only smoking is withdrawn—not too alarming—then pull the sites where there should be a decline and the rates become terrifying. Again, the general lack of decline indicates a crisis.

July-August 1990, ATC 27