A hazardous society? Individual versus community responsibility in cancer prevention. Third annual Matthew B. Rosenhaus Lecture

Our plain-English summary of A hazardous society? Individual versus community responsibility in cancer prevention. Third annual Matthew B. Rosenhaus Lecture, by J. Higginson (American Journal of Public Health, 1976).

The study

• Author: J. Higginson
• Journal: American Journal of Public Health
• Published: 1976;66(4):359-66
• Cited by: 33 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 002289).

Summary of the article

This article is the text of the Third Annual Matthew B. Rosenhaus Lecture, given at the 103rd Annual Meeting of the American Public Health Association in Chicago in November 1975 by the director of the International Agency for Research on Cancer. The author reviewed environmental and occupational causes of cancer and discussed the roles of the individual and the community in primary prevention. He traced the history of the subject from Percival Pott's 1775 description of scrotal cancer in chimney sweeps. He stated that the causes of 30-40 per cent of cancers in European and American industrial societies had been identified, chiefly cultural habits such as smoking, drinking and sun exposure, and that occupational cancers made up an estimated 1-3 per cent. Using mainly United Kingdom data, he expressed risks as deaths per 100 men by age 65. He calculated that a non-smoking asbestos worker might raise his risk of death by age 65 from 30 to 33 per 100 through mesothelioma. He calculated that a heavy-smoking asbestos worker might theoretically face a lung cancer risk of the order of one in two. He gave comparable figures for vinyl chloride. In a hypothetical population of 100 million males, he estimated that non-smoking asbestos workers would contribute about two lung cancers a year and smoking asbestos workers about 270, out of roughly 60,000 in total. He concluded that personal action through a "Personal Cancer Plan" offered the greatest immediate benefit, and that governments, employers and unions still had to control exposures. He also argued that scientists should express risks clearly.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This article is the text of a 1975 lecture, not a new study. The author reviewed environmental, occupational and lifestyle causes of cancer and argued that individuals and communities share responsibility for prevention. Using mainly United Kingdom data, the author made simplified illustrative risk calculations, with rounded figures and no allowance for competing causes of death. Citing earlier studies, the author stated that non-smokers in the asbestos industry had not been shown to have an appreciable lung cancer risk compared with the general population, but did show an increased risk of mesothelioma. The author calculated that a non-smoking worker exposed to certain types of asbestos might raise the risk of death by age 65 from 30 to 33 per 100 through mesothelioma. A heavy-smoking asbestos worker's chance of dying of lung cancer might theoretically be about one in two. The author suggested the risk appeared largely controllable if crocidolite, and preferably amosite, were avoided and other types reduced. The author concluded that the greatest near-term benefits would depend on personal action.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Published lecture (narrative review of environmental and occupational cancer hazards with simplified illustrative risk calculations); not an original study
• Who was studied: No study population. The calculations used mainly United Kingdom population data and a hypothetical population of 100 million males in an industrialized society.
• Exposure: Cigarette smoking, alcohol, diet, sunlight and occupational carcinogens. For asbestos, the article refers to crocidolite, amosite and 'other types of asbestos'. Vinyl chloride is also discussed.
• Main results:
  • Citing earlier studies, the author stated that a non-smoker in the asbestos industry had not been shown to be at appreciable risk of lung cancer compared with the general population (smokers and non-smokers combined), but did show an increased risk of mesothelioma and certain other tumours.
  • By the author's calculation, a non-smoking worker exposed to certain types of asbestos may possibly increase his risk of death by age 65 from 30 to 33 per 100, due to mesothelioma.
  • The author stated that this risk would appear to be largely controllable if exposure to crocidolite and preferably amosite were avoided and exposure to other types of asbestos reduced.
  • For an asbestos worker who is a heavy smoker, the author calculated that the chance of dying of lung cancer may theoretically be of the order of 50 per cent (one in two). The author noted that this does not happen because competing causes of death must be considered.
  • In the illustrative Table 1 (100 million males per year), the figures were as follows. Non-smoking asbestos workers (assuming 10,000 at risk): incidence 16 per 100,000, 2.4 cases, assumed relative risk 2. Smoking asbestos workers (assuming 30,000 at risk): incidence 560, 210 cases, relative risk 70. The relative risk of 2 was assumed because insufficient data were available.
  • In the United Kingdom, by age 65 among non-smoking men, 30 per 100 will have died from all causes, 10 from cancer and one from lung cancer. Among smokers the figures were 40, 15 and 10.
• The authors' conclusion: The author concluded that in the immediate future the greatest benefits would depend on personal action (a 'personal cancer plan'). The author also stated that this does not reduce the duty of governments, legislators and employers to make the environment as safe as possible, and that scientists should avoid overstatement and express risks in terms the public can understand.
• Limitations the authors state:
  • The figures were simplified for demonstration purposes.
  • The cancer figures were rounded, and competing risks were not calculated.
  • In most industrial societies, data on populations exposed to specific risks are not available.

Topics

Medical terms in this study, explained in our Lexicon: Habit, Mesothelioma, Lung Cancer.

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