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ABSTRACT
The past decades have seen a rising trend in cancer cases throughout the world. This paper explores the major debates past and present that have attempted to explain those trends. The first part of the paper discusses differing perspectives on cancer causality and situates the role of populations at risk in helping to resolve aspects of the scientific quandary. The second part critically examines the historical debate within the scientific community regarding the aetiology of cancer beginning with the hypotheses presented by Hueper and Carson. The third section examines the differing perspectives regarding the attributable risks of cancer as exemplified by the epidemiologists Doll and Peto and contrasts these with the work of the physician and toxicologist Epstein. The final sections of the paper draw on recent insights into the role of hormonally mediated substances and their potential deleterious role with regards to breast cancer and highlight some of the systemic barriers within the 'cancer establishment' that prevent the resolution of this conflict.
BACKGROUND
There is no established consensus within the scientific community regarding attributable cancer risks posed by such aetiologic factors as lifestyle, genetic susceptibility, viruses, reproductive factors, and environmental and occupational exposures.
The two principal perspectives that have dominated the scientific controversy surrounding the risk factors that contribute to cancer causality can broadly be described as personal lifestyle risk factors versus the more socially determined environmental risks factors, which include exposures to synthetic chemicals (Clapp et al., 2008; Colborn et al. 1999, p. 183; Landrigan et al., 2011; Steingraber, 1997; Gray et al., 2009). There is also a variety of opinions that exist along a continuum between these two perspectives (Walker, 1998; Clapp, 1998; Landrigan and Markowitz, 1989; Davis and Muir, 1995; Infante, 1995; Rose, 1992). These divergent perspectives have socially influenced the construction of cancer science including funding proposals and study design.
A further synthesis of these diverse perspectives should include an alternative proposition. Given the current evidence, the incidence of cancer may be related to a variety or combination of factors, including environmental, occupational, genetic, lifestyle and socioeconomic factors that should all be included in future epidemiologic studies (Brophy, 2004; Gray et al., 2009; O'Neill et al., 2007.).
The scientific tools of epidemiology and toxicology, after being mired...