NCI director ignorant of cancer prevention, says coalition

The following is an opinion editorial provided by Samuel S. Epstein, M.D., Chairman of Cancer Prevention Coalition, and his colleagues:

“you can't do research to see what causes cancer”

On October 22, 2010, Senator Chuck Grassley, ranking member of the Senate Finance Committee, wrote to Dr. Harold Varmus, who was appointed director of the National Cancer Institute (NCI) by President Obama three months previously. The Senator raised questions on the amount of "sponsored travel," sometimes a dozen or more trips a year and almost exclusively to international conferences paid for by outside organizations or companies, taken in recent years by "numerous NCI employees, notably senior leadership." According to ScienceInsider, many of the 16 scientists involved took at least 10 trips a year in 2008, 2009, and 2010. One of the frequent fliers took 33 trips in 2008 and 2009, while another took 11 from October 2008 to March 2009.

Varmus has a distinguished track record on basic research on cancer treatment. However, this is paralleled by frank and dangerous unawareness of longstanding, well-documented scientific evidence on the causes and prevention of cancer. As long ago as 1998, in Natalie Angier's Natural Obsessions book, Varmus claimed, "You can't do experiments to see what causes cancer - it's not an accessible problem, and not the sort of thing scientists can afford to do - everything you do can't be risky."

The claim by Varmus that "you can't do research to see what causes cancer" reflects dangerous ignorance which should disqualify him from the NCI directorship. The International Agency for Research on Cancer (IARC) has published annual reports on carcinogens, largely based on carcinogenicity tests on rodents since 1964. Until 2004, the National Toxicology Program (NTP) has also published systematic and comprehensive reviews on carcinogens, again largely based on carcinogenicity tests, since 1980. Both the IARC and NTP reports reflect decades-old unarguable scientific evidence on "what causes cancer."

The ignorance of Varmus to cancer prevention is reinforced by his unrecognized personal conflicts of interest. In 1995, Varmus, then director of the National Institutes of Health, struck the "reasonable pricing clause," as detailed in my 2002 publication in the International Journal of Health Services. This clause protected against exorbitant industry profiteering from the sale of drugs developed with taxpayer money. Varmus also gave senior NCI staff free license to consult with the cancer drug industry, a flagrant institutional conflict of interest. In this connection, the 2008 edition of Charity Rating Guide & Watchdog Report listed Varmus with a compensation package of about $2.7 million. According to The Chronicle of Philanthropy, this is the highest compensation of directors in over 500 major non-profit organizations ever monitored.

As disturbing, is the longstanding abdication of responsibility by the NCI, the primary federal institute explicitly charged by President Richard Nixon in 1971 to fight the war against cancer. This charge clearly prioritized the allocation of adequate resources to investigate and eliminate known avoidable causes of cancer. However, while the NCI budget has escalated 25-fold, from $200,000 in 1971, to over $5 billion currently, this has been paralleled by an escalation in the incidence of a wide range of cancers. These include liver, 165%; thyroid, 145%; non-Hodgkin's lymphoma, 82%; childhood, 24%; and breast, 19%. These increases also reflect the NCI's longstanding and reckless indifference to prevention, matched by exclusionary emphasis on treatment and related research.

Reflecting these disturbing concerns, a July 29, 2003 report by the National Academy of Sciences, requested by Congress, charged that:

• The leadership of NCI is marred by pervasive conflicts of interest, and a revolving door with industry, particularly the cancer drug industry.
• Contrary to NCI's exaggerated claims and misleading public assurances, overall cancer incidence rates, including those of childhood and non-smoking adults, have sharply escalated over recent decades.
• NCI policies and priorities remain fixated on damage control - screening, diagnosis, and treatment and related research--with minimal priorities for prevention.
• Contrary to the requirements of the 1971 National Cancer Act, the NCI has still failed to inform the public of a wide range of avoidable causes of cancer. This denial of the public's right to know has even been extended to the withholding of readily available scientific information.

These criticisms of the NCI are as germane and timely today as they were seven years ago. However, and disturbingly so, they remain unrecognized by Congress, let alone the public. As President Obama has stated in September 2008, "It is critical to understand the relationship between environmental factors and risk or onset of disease, particularly cancer."

SOURCE Cancer Prevention Coalition