Of Course Cancer Isn’t Random
Of course, even the most apparently random of terrible fate may not be truly, completely random. We have abused our planet in innumerable ways and riddled our environment with a vast inventory of toxins. Perhaps some of the most seemingly random cancers to affect the human body are related to such transgressions by the body politic. Similarly, a stray bullet and its victim can be utterly random- but such a tragedy is more likely, and more common, in a society with a highly permissive attitude about guns and the profits attached to their exchange.
In such ways, then, cancer can be “random”- but overwhelmingly, it is not.
The evidence we have that cancer is often, even routinely preventable by choices we can make singly (i.e., lifestyle), or collectively (i.e., policy, and the social/environmental determinants of health), is nothing short of incontrovertible. We have clear data linking a number of modifiable exposures, tobacco salient among them, to cancer incidence. We observe enormous variations in cancer rates, both in general and of specific types, among different populations around the world. We even observe an enormous change in cancer rates when the same population, with the same genes, changes its environment and lifestyle. How, then, could it be- as the prevailing coverage of the new paper in Science suggests- that cancer is mostly about “bad luck”? It cannot be, and it is not.