Friday 2 January 2015

Bad luck and cancer

The news that most cancers are due to bad luck, not lifestyle factors, genetics or the environment, is on the front page of several newspapers today. Here's a snippet from the Beeb:

Most types of cancer can be put down to bad luck rather than risk factors such as smoking, a study has suggested.

A US team were trying to explain why some tissues were millions of times more vulnerable to cancer than others.

The results, in the journal Science, showed two thirds of the cancer types analysed were caused just by chance mutations rather than lifestyle.

In some respects, it is surprising that this study has made such a big splash. It does not claim that all cancers are due to bad luck. On the contrary, it attributes a substantial minority to lifestyle factors such as smoking. Did people really think that most or all cancers are due to bad habits? Perhaps they did, but if the findings seem counterintuitive it is because of the lingering, primitive belief that ill health is the result of sinfulness and that those who develop cancer somehow deserve ita belief that is eagerly fostered by the neo-puritans of 'public health'.

I got a sense of déja vu when I read this story as it seemed remarkably similar to a story that came out only last week.

Life choices 'behind more than four in 10 cancers'

More than four in 10 cancers - 600,000 in the UK alone - could be prevented if people led healthier lives, say experts.

Latest figures from Cancer Research UK show smoking is the biggest avoidable risk factor, followed by unhealthy diets.

This is really just another way of imparting the same information. 'Large minority of cancers caused by lifestyle factors' is no different to 'Most cancers not caused by lifestyle factors' except in its emphasis, as I said at the time.

But the change in emphasis is very significant. The Boxing Day story was inspired on a Cancer Research UK press release whereas today's report is based on a study published in Science. Moreover, the CR-UK press release gives a much higher estimate of how many cancers are lifestyle related. It attributes more than 40 per cent to lifestyle factors (smoking, diet and drinking, mostly) whereas the new study finds that only a third of cancers are due to lifestyle factors, environmental factors and hereditary factors combined.

And whereas the Science study is a serious piece of research written by two oncologists and published in a peer-reviewed journal, the CR-UK press release was based on a back on the envelope estimate by CR-UK statisticians and appeared to have been designed primarily to give CR-UK an excuse to promote 'standardised' packaging and assure the public that 'we do not want to ban mince pies'.

It may be a coincidence, of course, but it makes you wonder whether CR-UK decided to put their figures out last week, with a heavy emphasis on things that can be banned, because they knew that the more circumspect Science study was coming out seven days later.


Christopher Snowdon said...

"....the lingering, primitive belief that ill health is the result of sinfulness and that those who develop cancer somehow deserve it—a belief that is eagerly fostered by the neo-puritans of 'public health'." I think you've hit the nail on the head there, Christopher Snowdon. And it links to the sense that public health is a kind of (secular) religion.

Christopher Snowdon said...

I've been seeing people coming on the TV, not people sorry but "experts" (lol) who are squawking that the information in this report is "dangerous"! Cripes. Because, apparently "a third of cancers are caused by lifestyle". No. I would be very, very interested in hearing the exact breakdown with regards to environment, genetics and lifestyle in that third, I really would.
In other news though, the "bad luck" part is pretty frightening to me given that my family is free from hereditary cancer so I thought I'd got off lucky...

Christopher Snowdon said...

CRUK's performance leaves a huge amount to be desired. You correctly expose the gulf in quality between their politically motivated output and the work of Tomasetti and Vogelstein in Science. With respect, Vogelstein is an oncologist but Tomasetti is a bio-statistician. It worries me that the BBC places undue emphasis on the CRUK contribution, which relies heavily on very questionable epidemiological meta-analysis from the World Cancer Research Fund. I personally do not believe anything from that source to be remotely scientifically credible and serious questions need to be asked about those at CRUK who, for whatever reason, think otherwise.

Christopher Snowdon said...

The tobacco control inquisitors will spin this to demonize smokers whatever the actual data suggests. Notice how they conflate all 'lifestyle' risks to amplify the impact. It doesn't matter if 1/3 or 2/5 are for lifestyle factors hey will count them all as smoking-related. Just as they will count a cancer as smoking-related if the patient smokes even if the actual cancer has another cause. The fact that they have to cherry-pick and manipulate data makes their case suspect.

This is similar to how they manipulated and fabricated hospital admission data after the smoking ban to justify the bans event though there was no actual, stable drop in admissions (they are still doing this).

The question is how do you get actual, reliable data countering the Puritan, tobacco control, lifestyle totalitarians. The media either parrots the prohibitionists or ignores dissent while politicians hide. The tobacco control myths get enshrined as dogma and each new lie is built upon the last.

Christopher Snowdon said...

Of course this report is dangerous! It 'sends the wrong message', that message being that the professional puritans have been lying and exaggerating for years.

It's 'dangerous' because it represents a clear and present danger to their comfy sinecures.

Ye Gods, if this report runs on in the press they might have to go out and get proper jobs! And they won't even get to bully anyone anymore! Heaven forbid! Time for some serious damage limitation. Watch for the flurry of press releases from ASH, CRUK et al talking up the perils of smoking and talking down the essential points of this report.

Christopher Snowdon said...

My concern is that if smoking has stabilised at 20% of the adult population and lung cancer incidence is increasing then why isn't vehicle and other particulate air pollution a headline?

Christopher Snowdon said...

"Did people really think that most or all cancers are due to bad habits?"

It may or may not be but the authors genius lay in guessing people might believe so and framing their work's findings and conclusions in such a manner.