Breast cancer, prevention and TSCA
Kathy Attar, MPH
March 22, 2016
Last October, I was diagnosed with invasive ductal carcinoma, a form of breast cancer. Fortunately, the cancer was diagnosed in the earlier stages and my long-term prognosis is good. I also have good health insurance and access to great healthcare providers. Many women-- especially low-income and women of color--aren't diagnosed until their cancer is advanced, lack insurance or adequate coverage, and don't have access to the latest treatment protocols. These disparities are illuminated in mortality rates: African American women have a 40% higher risk of dying from breast cancer than white women, and Latinas have a 20% higher risk.
Having worked with advocates at the local and national level for the past 10+ years to reduce exposures to harmful chemicals in our environments, I wasn't as shocked by my diagnosis as I suspect others not in the field might be. As part of my work, I've read the research on the rising rates of diseases linked to environmental pollution and the high costs to society. For example, a study by New York University revealed over $100 billion a year in health care costs in the European Union that are associated with diseases linked to endocrine-disrupting chemicals (EDCs), including IQ loss, ADHD, infertility, and diabetes-diseases that have also been increasing in the U.S.
Exposure to EDCs has also been linked to an increased risk of breast cancer.
Because of my age (I turned 40 last December), I had genetic testing done. I was found to be negative for the BRCA 1 and 2 genes. Having a BRCA gene mutation is uncommon; inherited BRCA gene mutations are responsible for only about 5% of breast cancers and about 10 to 15% of ovarian cancers. So while I will never definitely know what "caused" my cancer, exposure to environmental pollutants may have played a leading or supporting role in the onset of my disease.
Which brings us to the connection between chronic disease and lax chemical regulation. Right now Congress is negotiating legislation that could help reduce our risk of exposure to harmful chemicals in our homes, communities and workplaces. They are reconciling two bills (Senate and House) aimed at updating the Toxic Substances Control Act (TSCA) of 1976. TSCA by most accounts is outdated and ineffective.
There is an opportunity for legislators to take the best, most health-protective provisions from both bills and develop the strongest possible final legislation. But they must ensure public health takes precedence over industry interests. For example, the Senate TSCA reform bill preempts states from taking action on a chemical while EPA carries out its assessment, creating a regulatory void. It also creates a low-priority chemical category, allowing chemicals to be given a green light for use without going through a rigorous safety evaluation and without full evidence the chemical is safe. These provisions, among others, must be left out of any final reform legislation.
When I expressed concern about my daughter's risk of breast cancer, doctors assured me that detection, diagnosis and treatment standards would continue to advance. Which is great - but what about prevention?
Reforming TSCA could aid in the prevention of diseases, including breast cancer, but only if Congress focuses on the fundamentals of reform and makes our health its priority. For example, ensuring state-level toxics legislation is allowed to continue is critical. In 2016, at least 12 states will consider policies to identify and/or require phasing out chemicals of concern. Another 14 or so will consider policies to phase out the use of or require labeling of toxic flame retardants in consumer products. Passing these state laws will benefit countless people who, like me, face the trials that cancer imposes on our families and lives.
Tell Congress public health must be their priority when reforming our chemical safety law.