Cancer: A Disease of Civilization? (Part I)

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Ralph W. Moss, Ph.D. Weekly CancerDecisions.com

Newsletter #45 07/23/02

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Cancer: A Disease of Civilization? (Part I)

Is cancer a disease of civilization? Is it related to

other diseases that seem to increase with

industrialization? If so, what are the implications for

readers living in the 21st century?

Back in the 19th century, many of the diseases that now

plague us were rare. Diabetes was twenty-seventh on the

list of causes of death in the statistics of the

Metropolitan Life Insurance Company in 1900. By 1950 it

had become the third leading cause of death. The famous

surgeon Alton Ochsner, MD, once related that, when he

was in medical school in the early 20th century, one of

his professors took his class to see the autopsy of a

patient who had died of a heart attack. The disease was

so rare at that time that his professor feared they

might never see another such instance! Obesity was the

subject of circus displays, not an everyday occurrence.

Similarly, until the mid-1800s, cancer was relatively

rare and was not considered statistically important.

This was particularly true outside of the major cities.

Then, in the mid-19th century, cancer began its

stratospheric rise. Around the same time, well-trained

medical personnel began to travel and even to live

among indigenous peoples (the so-called " natives " ). The

news they brought back was startling. These diverse

populations, many of whom lived a hand-to-mouth

existence, were generally much healthier than their

Western counterparts. True, they had a high infant

mortality rate and easily succumbed to epidemics that

originated in the West such as measles, smallpox and

tuberculosis. But they had far less asthma, allergies,

indigestion, and heart disease. The same disparity in

health was seen between rural and urban populations in

Europe. The French or English farmer was much less

likely to develop cancer than the cosmopolite of Paris

or London. And despite the stereotypical image of

Eskimos and South Sea islanders as roly-poly, obesity

was extremely rare among such people.

Most startling of all, cancer seemed nonexistent. In

1843, a French surgeon, Stanislas Tanchou, MD,

formulated this observation into " Tanchou's Doctrine " :

the incidence of cancer increases in direct proportion

to the " civilization " of a nation and its people. This

doctrine was embraced by Le Conte, MD (1818-1891),

first president of the University of California, and

his enthusiasm led medical missionaries, ship surgeons,

anthropologists and others to undertake an avid search

for cancer among the Alaskan Eskimo (Inuit), northern

Athapaskans of Canada and the native peoples of

Labrador. The result was always the same: For 75 years,

not a single case of cancer was documented among the

tens of thousands of such people studied by competent

medical examiners. The Harvard-trained anthropologist,

Vilhjalmur Stefannson, for instance, lived for 11 years

among the Eskimo and never saw a case. In later life,

he wrote a book on the topic, Cancer: A Disease of

Civilization?

Unfortunately, whatever protection these native

populations had against cancer was lost when they began

to adopt Western ways in the 1920s. By the early 1930s,

cases of cancer were being documented in Alaska and

Canada. On July 27, 1933, an Eskimo named Jobe died of

liver cancer at the Farthest North Hospital in Alaska.

Similarly, in 1935, Nochasak, an Eskimo, died

of colon cancer in Labrador. After that, the rates of

cancer among these native peoples underwent a steady

rise, until they began to rival that of the white

population.

Evidence from Africa and Asia

Similar stories are told about the indigenous peoples

of Africa and Asia. Albert Schweitzer, MD, the famous

Nobel laureate, testified as follows:

" On my arrival in Gabon, in 1913, I was astonished to

encounter no case of cancer...I cannot, of course, say

positively that there was no cancer at all, but, like

other frontier doctors, I can only say that if any

cases existed they must have been quite rare. The

absence of cancer seemed to me due to the difference in

nutrition of the natives as compared with the

Europeans...

" In the course of the years, we have seen cases of

cancer in growing numbers in our region. My

observations incline me to attribute this to the fact

that the natives were living more and more after the

manner of the whites...I have naturally been interested

in any research tracing the occurrence of cancer to

some defect in our mode of nutrition. "

The Hunza people, who live in a remote valley of the

Himalayas, in the territory of Kashmir, provide further

evidence of the rarity of cancer among indigenous

populations. The Hunza were the subject of study from

the 1910s onward by a number of diligent observers,

including Sir McCarrison, Major General in the

Indian Health Service (1878-1960). McCarrison's seven

years of careful scrutiny led him to conclude that there

was little if any cancer among this population.

It might be objected that cancer is an " occult "

disease, difficult to diagnose, and that for this

reason it may have eluded early observers. I do not

believe this to be the case. At least one-quarter of

all cancers are external in nature. Basal and squamous

cell carcinomas, tumors of the head and neck region,

breast cancer and those of the external genitals, to

name but a few, are all readily apparent and do not

take great diagnostic skills to detect. Breast cancers

in particular were well known and described even by

ancient physicians. Other cancers also form noticeable

lumps or break to the surface.

Besides, we are not talking about medieval medicine. By

the late nineteenth and early twentieth centuries

cancer pathology had taken great strides. Such works as

Ewing's Neoplastic Diseases, which was first

published in 1920, demonstrate the sophistication of

cancer science at that time. Frontier doctors were, by

and large, competent, serious and well-trained. I don't

think there is any doubt that if cancer had been

widespread, they would have found it. I can only

conclude that cancer is indeed a disease of industrial

society.

--Ralph W. Moss, Ph.D.

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References:

Stefannson V. Cancer: Disease of Civilization? NY: Hill

& Wang, 1960.

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