Primary prevention and a role for clinicians as trusted communicators - barriers and opportunities


Introduction: Forward-looking strategies to catalyze environmental cancer prevention.

  • Julia Brody, PhD - Executive Director and Senior Scientist, Silent Spring Institute


  • Margaret Kripke, PhD - Professor Emeritus and founding chair of the Department of Immunology at the University of Texas MD Anderson Cancer Center, Co-Panelist on the President’s Cancer Panel
    • Missed opportunities for primary prevention of environmental cancers.
  • David Michaels, PhD, MPH - George Washington University School of Public Health
    • Author of The Triumph of Doubt on the challenge of defending public health science when it is targeted by chemical and drug makers sowing doubt. slides
  • Ruthann Rudel, MS - Director of Research, Silent Spring Institute
    • Chemicals that increase synthesis of estrogen and progesterone as risk factors for breast cancer: A case study for 21st century approaches to identifying likely carcinogens. slides

Panel: What to say to your patients, policymakers, and to the news media about chemicals and cancer when the science is uncertain.

Moderator: Julia Brody

  • Phil Landrigan, MD - Director, Global Public Health Program, Boston College
    • Experiences of a pediatrician giving everyday advice and also speaking publicly about potential causes of cancer and other diseases without blaming patients. slides
  • Amy Kostant, MA -  Executive Director, Science Communication Network
    • Practical guidance for scientists and clinicians to advance public understanding via the news media.
  • Gary Ellison, PhD, MPH - National Institute of Environmental Health Sciences and National Cancer Institute
    • New cohorts and other research to integrate environmental exposure and social determinants of health to advance equity

Closing Remarks/Reflections: The Role of Cancer Centers in Advancing Environmental Prevention

  • David Read, Vice President of Medical Oncology at Dana-Farber Cancer Institute
  • Julia Brody, PhD - Silent Spring Institute


Primary prevention means reducing cancer deaths by reducing cancer incidence. It precedes mammograms or colonoscopy or other screening methods that are designed to detect cancers when they are treatable. Dr. Margaret Kripke reviewed trends in cancer rates, including among younger people, and gaps in regulatory policies and enforcement that indicate large opportunities for future cancer prevention. Speakers addressed how healthcare providers can contribute to prevention by using their trusted role in their communities to support policies and individual actions to reduce exposures to harmful chemicals in everyday environments. The “characteristics of carcinogens” framework used by the International Agency for Research on Cancer (IARC) offers a basis for evaluating opportunities for prevention using evidence from experiments in animals and cells as well as observational epidemiology. For example, a novel analysis using US EPA data identified 300 chemicals that increase production of estrogen or progesterone in laboratory assays, raising red flags for breast cancer risk. Dr. David Michels cautioned that industry-funded science, which follows the playbook of the tobacco companies and climate deniers, too often blocks safety measures by creating doubt.

A discussion with a physician, communications expert, and research leader from the National Cancer Institute addressed how healthcare providers can focus on what we do know now while supporting future research to learn more. They can communicate respectfully with patients, including those in marginalized groups, and be advocates for systems change. The discussion noted easy-to-use, science-based resources for patients, such as the Detox Me mobile app and the Clearya Chrome extension. 

Additional Materials

Session 3 recording

Q&A and resources


Forum Overview

Session 1

Session 2