Devra Davis’s book The Secret History of the War on Cancer (which we covered favorably here and here) advocates shifting our emphasis from treating cancer to preventing it – and, in particular, focusing on environmental factors implicated in the explosion of certain types of cancer. The book has raised some controversy, and a recent exchange in the New York Review of Books exemplifies one of the points of contention. Gayle Green writes in a letter responding to Richard Horton’s review:

Horton has granted that Davis has a point, that the inexplicably high incidences of cancer in some parts of the world suggest environmental influences. He seems convinced by her analysis of the “misplaced emphasis on treatment over prevention,” mentioning the strategy of “doubt promotion,” the casting of aspersions on scientists who don’t toe the party line. Yet he concludes that the real reason cancer is on the rise is that people smoke and eat too much. It’s a familiar ploy, this reduction of a politically charged issue to a matter of individual self-control—it is “doubt promotion” at work.

In her book, Davis stresses that lifestyle factors do play a major role in cancer; her point, however, is that we can best reduce cancer incidence by responding to both lifestyle and environmental factors. We should all remember that cancer prevention can and should take multiple forms.