International Journal of Epidemiology 2002;31:1027-1029
© International Epidemiological Association 2002
Cancer |
Commentary: Epidemiology on the side of the angels
INRS—Institut Armand Frappier, Université du Québec, 531 Boul. des Prainés, Laval, Quebec H7V 1B7, Canada. E-mail: jack.siemiatycki@inrs-iaf.uquebec.ca
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Hurtig and San Sebastián1 have examined cancer incidence rates in a region of the Amazon basin of Ecuador and ostensibly found higher cancer rates in the area closer to oil extraction sites than in the area further away; they concluded that this should lead to the establishment of systems of environmental monitoring and control, and of cancer surveillance. The conduct and publishing of this work raise several issues, of which I will comment on three: the strength of evidence that this study affords, the replicability of this study; and the public health recommendations that can be made.
Strength of evidence from this study
Research on cancer in developing countries is difficult. Among the major problems is the fact that diagnosis of cancer is a fairly high-tech and expensive enterprise, not readily available to the majority of inhabitants of many developing countries. Available statistics on cancer incidence and mortality in most developing countries are probably incomplete, of
Replication of studies—consistency of evidence
Justification for public health recommendations
General remarks
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