4.3 Article

Difficulties in establishing a causal link between chemical exposures and cancer cannot be overcome by court assessments

期刊

HUMAN & EXPERIMENTAL TOXICOLOGY
卷 39, 期 8, 页码 1095-1107

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SAGE PUBLICATIONS LTD
DOI: 10.1177/0960327120911426

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Asbestos; associations; causal inference; estimates; glyphosate; tumor heterogeneity; non-Hodgkin lymphoma; mutation load; observational research; ovarian cancer; risk factors; talc

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Scientific data are often used in lawsuits to prove, or dismiss, causation by a claimed factor of a claimed disease. Recent media reports of million-dollar compensations awarded to some cancer patients who had been exposed to certain chemical substances motivated me to examine how solid the causal links really were. Here, I discuss the limitations of epidemiological research on cancer causation and highlight how new knowledge of cancer genetics makes it unrealistic to expect that cancer causation can be clearly demonstrated. I then present two exposure-cancer cases, namely talcum powder-ovarian cancer and glyphosate-non-Hodgkin lymphoma, that led to civil lawsuits decided, in the United States, in favor of the claimants. Both these cancers have several risk factors, among which the claimed exposure presents only a minor, if any, increased risk. Through these cases, I explain why the use of epidemiological data is inappropriate to define causal associations in complex diseases like cancer. I close by suggesting a fairer approach, called proportional liability, to resolving future cancer litigation cases.

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