Cancer

Cancer. Cancers are malignant tumors or malignancies that arise in bone marrow or lymph nodes and spread to other tissues or organs. The oldest cancers in the Americas are those found in the bones of fossilized dinosaurs; cancers no doubt also afflicted the earliest human beings on the continent, who arrived about twelve thousand years ago. Little is known about cancer rates prior to the nineteenth century, though lip and lung cancers were probably not uncommon among native smokers of tobacco. Natural sources of radiation—like radon or ultraviolet solar radiation—must also have contributed to the occasional lung or skin cancer, though cancer rates as a whole were probably lower than those for subsequent generations of European colonists.

John Le Conte (1818–1891), a professor of physics at the University of California after the Civil War, was one of the first Americans to suggest that cancer was on the rise. Le Conte portrayed cancer as a “disease of civilization,” though it did not surpass tuberculosis as a cause of U.S. mortality until the 1920s. (Heart disease was already in first place, a position it held through the twentieth century.) One reason for the transition was that life expectancy was increasing, pushing more people into the cancer‐prone years. Age‐adjusted mortality rates began to be calculated about this time, though statistical record‐keeping remained rudimentary. Federal mortality statistics did not distinguish among different kinds of cancer until the early twentieth century; the first population‐based registry was not established until 1937, in Connecticut.

Cancer rates grew rapidly after World War II, bucking the trend of diseases—like syphilis and poliomyelitis—that were succumbing to scientific medicine. Funding for the U.S. National Cancer Institute, established in 1937, increased dramatically in the 1950s, but environmental or lifestyle causes of cancer received little attention. Wilhelm Hueper's Occupational Tumors and Allied Diseases (1942) set the stage for the view that “the environment”—including diet and tobacco products—was responsible for most human cancers, a view later endorsed by the World Health Organization (Prevention of Cancer, 1964).

Rachel Carson's widely read Silent Spring (1962)—based partly on Hueper's work—fueled the idea that environmental pollution might be partly to blame for increasing cancer rates, though epidemiological studies by Richard Doll, A. Bradford Hill, and Ernst Wynder in the early 1950s showed that cigarettes bore responsibility for most of the increase. The U.S. surgeon general in 1964 identified tobacco as a major cause of cancer; smoking rates for men peaked at about that time, though lung‐cancer rates would continue to rise for another quarter of a century. Lung cancer had become the leading cause of cancer death among males by the early 1950s; among women, mortality from lung cancer did not surpass breast cancer mortality until the 1980s.

President Richard M. Nixon in his 1971 State of the Union address declared a “war on cancer”; the National Cancer Act of that same year signaled major increases in research funds devoted to cancer. The National Cancer Institute became the largest single unit of the National Institutes of Health, reporting directly to the president, with an annual budget that surpassed two billion dollars by the 1990s. Many scientists hoped that a cancer vaccine might be found to eliminate the disease, as had been the case with polio and smallpox.

In the 1970s, labor and environmental activists such as Samuel Epstein (The Politics of Cancer, 1978) began to protest the failure of the National Cancer Institute to address the causes of cancer in a manner that might lead to effective prevention. Lung cancers and other internal tumors began to appear in tens of thousands of asbestos workers, especially shipyard workers who had sprayed the mineral inside ships in World War II. Widely publicized cases of cancers caused by vinyl chloride, benzene, dry‐cleaning fluids, hair dyes, and other petrochemicals gave rise to the widespread and controversial notion that the modern chemical environment was causing unprecedented numbers of cancers.

Cancer rates continued to climb until the early 1990s, by which time the decline in smoking was resulting in lower cancer rates. Cancer mortality rates fell by about 3 percent from 1990 to 1995, the first clear drop since data had begun to be recorded. Cancer rates remained particularly high for African Americans, though most observers believed the inequality had more to do with environmental factors relating to poverty than with race‐specific organic factors. As the twentieth century ended, cancer rates had still not fallen as much as deaths from heart attack, apparently because treatments for heart failure had improved much more rapidly than treatments for cancer. Projections suggested that cancer would become the number‐one cause of U.S. deaths sometime early in the twenty‐first century.
See also Disease; Environmentalism; Food and Diet; Medicine; Tobacco Industry; Tobacco Products.

Bibliography

Richard Doll and and Richard Peto , The Causes of Cancer, 1981.
James T. Patterson , The Dread Disease: Cancer and Modern American Culture, 1987.
Robert N. Proctor , Cancer Wars: How Politics Shapes What We Know and Don't Know about Cancer, 1995.

Robert N. Proctor

; Updated by

Paul S. Boyer