Book Review: Commerce and Cancer

This book is a sequel to Epstein’s influential The Politics of Cancer and examines the dangers to health of carcinogens in industry, food additives, tobacco, environmental pollution, drugs such as female sex hormones and oral and injectable contraceptives in Britain.

Cancer is regarded by the authors as a preventable disease and they are critical of the curative emphasis that dominates most research, pointing out that the rates of cure for most major cancers have improved only slightly in the last 30 years. There are marked differences in the cancer rates of urban and rural areas, with very high rates of lung and stomach cancer in the industrialised inner-city areas — a pattern previously observed in the United States. The major cancers are common among semi-skilled and unskilled workers, particularly men, probably reflecting in part their greater exposure to occupational carcinogens.

The authors explain that there are two distinct approaches to cancer causation — the “establishment” approach which argues that occupational cancers cause less than 5 per cent of all cancers and resists attempts at regulation of industry, claiming that people’s “life-styles” are responsible; and the “radical” approach which argues that 20-40 per cent of cancers are work-related and aims at better health and safety measures at work.

A comprehensive account is provided of the dangers of working with carcinogens; how industry resists attempts to make working conditions safer and how comparatively few people are able to obtain compensation once they have developed cancer through their work. The difficulty of regulating industry is increased by the manufacturers’ secrecy, although as ASTMS have pointed out:

The pursuit of profit, not lack of knowledge, lies behind the failure to make the working environment safer. There are, for example, about 2.000 asbestos-induced deaths each year and although a Home Office report pointed out the dangers as long ago as 1906, regulations to control the levels of asbestos dust were not introduced until 1932.

The most flagrant examples of commercial interests influencing the regulation of dangerous substances can be seen in the case of the pesticides aldrin and dieldrin, which are banned in the United States but used and manufactured exclusively in Britain, and chlordane and heptachlor which are restricted in Britain but made and used in the United States. The failure of successive governments to regulate the tobacco industry and prevent the 50,000 deaths a year caused, at least in part, by smoking is influenced by the £4,000 million received every year from tobacco tax. The book points out that “. . . the financially precarious newspaper industry earns more than £30 million each year from advertising, a fact reflected in the consistent refusal of newspapers to criticise the industry or to support campaigns for stricter regulation” (page 81).

Perhaps the most tragic aspect of the use of carcinogens has been in the treatment of pregnant women with diethylstilboestrol, mainly in the 1950s. The drug actually increased miscarriages and baby deaths instead of preventing them, caused abnormalities in the offspring and an increase in the incidence of breast cancer.

In a chapter devoted to fighting the causes of cancer it is stated that “The problem is inherent in the nature and priorities of a society in which the profit motive is predominant” (page 147). Reformist measures such as campaigning for a Freedom of Information Act and more public participation in decisions are advocated and are doomed to failure under capitalism because of their effects on profitability. Socialism is not mentioned.

Nevertheless, despite its faults, this book is well researched, well referenced and provides a lot of useful information about how one-fifth of us will die prematurely to provide profits for capitalism.