We’re missing a critical opportunity to prevent childhood cancer 

My sister was diagnosed with thyroid cancer when she was 25 years old. I was 27 at the time, living abroad and teaching English. When she got her diagnosis, I moved home to help during her surgery and treatment.  

Twenty-five is young for a cancer diagnosis, but stories like hers are increasingly common — cancer is on the rise among millennials and young people. Since health officials began collecting data in the 1970s, charts tracking cancer in children and young adults are distressingly uniform, with diagonal lines steadily climbing upward. 

In the U.S., rates of childhood leukemia, the most common type of childhood cancer, increased 35 percent from 1975-2019; childhood brain cancer rose by 33 percent. Today, one in 285 Americans are diagnosed with cancer before their 20th birthday. Cancer is the leading cause of death by disease for American children.  

These increases are too rapid to result from genetic changes, which happen over centuries, not decades. Nor are they clearly the result of better diagnostic tools: The tools for diagnosing childhood leukemia, for example, remain unchanged since the 1970s. Behavioral choices — such as smoking and drinking — cannot explain the increase in childhood cancer. 

This is a real, rapid increase in childhood cancer rates. If it’s not a result of genes or behavior, it’s likely caused by something in the environment. And one thing in our shared environment has changed substantially during this same period: the number of manufactured chemicals we’re exposed to on a daily basis.  

In the last 100 years, more than 300,000 new manufactured chemicals have been invented. 

Many of these chemicals have improved our lives: Disinfectants bring safe drinking water to millions and reduce deaths from dysentery, for example. But we also know that manufactured chemicals can cause great harm. Agent Orange had brutal effects that have spanned multiple generations. Chlorofluorocarbons nearly destroyed the ozone layer before being phased out. 

Most new chemicals are never tested for safety, and fewer than 20 percent are evaluated for their potential to harm fetuses, infants and children. Even when chemicals are tested and found to be dangerous, they generally stay on the market — at least in the U.S. The World Health Organization has identified at least 100 manufactured chemicals that can cause cancer in humans, but only five have been removed from U.S. markets in the last 50 years. 

Chemicals get into our bodies through our air, water and food, and by being absorbed through our skin. Several hundred are found in the bodies of almost every person on Earth, including infants and children. Many are carcinogens or endocrine disruptors, which interfere with hormonal processes in ways that increase cancer risk. A growing body of research suggests that even very small doses of many chemicals increase our health risks in big ways. 

Children, with their smaller bodies, are especially vulnerable to this constant barrage of chemicals. Their bodily systems are still developing — processes that require healthy hormonal systems to happen in precise order. And because those systems aren’t yet fully developed, children’s bodies are also less capable than adults of filtering out toxic substances. Even scarier: Research suggests that parents,’ grandparents’ and even great-grandparents’ chemical exposures can increase a child’s risk of disease.  

Yet in the U.S., carcinogens and endocrine-disrupting chemicals are hardly regulated at all. Many chemicals that are banned in other parts of the world are common in processed foods and personal care products sold here.  

An estimated 90-95 percent of all cancers are caused by preventable factors. But globally, only 7-9 percent of all cancer funds go toward prevention. In our “war on cancer,” this equates to spending about 90 percent of our war budget on treating wounded soldiers, and less than 10 percent on measures that could keep them from getting hurt in the first place. 

Pursuing new cures and treatments is critical, but we could be doing much more to prevent cancer.  

The Biden administration should incorporate efforts to reduce exposure to carcinogens into its federal Cancer Moonshot plan. As the administration continues its efforts to rebuild the American economy, lawmakers should prioritize a transition away from chemicals that raise our cancer risk, and toward the safer alternatives that are already being produced through significant advances in green and sustainable chemistry. 

The U.S. Environmental Protection Agency (EPA) should take additional steps to protect people from toxic chemicals like PFAS — a.k.a. “forever chemicals” — pesticides and other known and suspected carcinogens by conducting additional safety testing, stepping up its enforcement of existing regulations, and enacting new regulations that prioritize human health and cancer prevention.  

States are leading the way when it comes to enacting new, more stringent regulations on these chemicals in drinking water, air pollution and consumer goods. It has been more than 30 years since Massachusetts passed its Toxics Use Reduction Act, which requires companies to track, document and report their use and disposal of certain toxic chemicals, and to make a plan for reducing their use over time. In the two decades following the law’s passage, the use of cancer-causing chemicals declined by 32 percent in the state and releases of known or suspected carcinogens into the environment declined by a whopping 93 percent.

California’s Proposition 65 informs consumers when carcinogenic chemicals are present in the products they buy. Groundbreaking PFAS legislation in Colorado, Minnesota, Maine and Washington State provide recent examples of how to regulate specific pollutants that increase cancer risk. Federal regulatory agencies should follow the lead of the state lawmakers executing these initiatives. 

The European Union also offers templates for better chemical regulations that still allow economies to flourish. The E.U.’s REACH program protects European consumers from many of the carcinogens Americans are exposed to on a regular basis. 

My sister was one of the lucky ones. She survived her cancer and has been in remission for more than a decade. I’ve had the joy of watching her get married and have two beautiful children.

I have also talked her through the anxiety she feels each time she goes in for a follow-up scan to make sure her cancer hasn’t returned. And I know that she, like most childhood and young adult cancer survivors, would rather have had prevention than a cure.

Kristina Marusic is the author of “New War on Cancer: The Unlikely Heroes Revolutionizing Prevention” and is an investigative reporter at Environmental Health Sciences.