Breast cancer conference marred by questionable presentations, critics charge

Barbara Sibbald

CMAJ 1999;161:584

Those were just examples of the dissenting opinions and controversial statements that made an appearance during the late-July meeting, but they weren't a major concern for Laurene Clark, president of the conference organizing committee. "It's not the scientific information, it's the interaction with women who live with the disease and hearing their point of view that's important," said Clark from her Kingston, Ont., office.

Besides, Clark thinks audience members were able to separate the wheat from the chaff. In addition to the health professionals who attended, many participants represented various breast cancer organizations. "These were very well-informed people," argues Clark.

Under the banner "Move Forward . . . Take Action," the conference was supposed to raise awareness of potential causes and risk factors, provide a chance for survivors to express themselves, develop international links and move forward to eradicate the disease. "We didn't focus on treatment," says Clark.

The predominantly female audience of about 1000 — some of the women were either bald or wearing turbans — heard the views of 220 presenters from more than 55 countries during 5 days of meetings. The first conference, held in Kingston in 1997, attracted about 800 delegates.

Dr. Steven Narod, head of breast cancer research at Women's College Hospital in Toronto, made a presentation at the first conference but wasn't invited back for this one. "The invited speakers were proponents of the [organizing committee's] position," says Narod, who attended the July conference because of his interest in the politics of breast cancer. "That's not a big secret."

In addition, most of the presenters weren't from university-affiliated research organizations, and he says that "this obfuscation of the boundaries of credibility" was in the interest of the organizing committee. "This was just a forum for the disenfranchised," he says.

Clark admits that some presenters "pontificated," which did "them and everyone else a disservice." Then there was the "unavoidable" problem of unsubstantiated statements delivered during volatile question-and-answer sessions. Still, she thinks the presenters did their job: "They raised a lot of questions and gave women more information. You're always going to have people who are way out on the left . . . but social change needs that."

She laments that the media chose to cover the more sensational aspects of the conference while neglecting survivors' stories. Some media also chose to blast the conference itself. Margaret Wente's July 31 Globe and Mail column ("Truth takes a holiday") concluded: "The consequence of this toxic stew of misinformation is false hope (get rid of chemicals and all will be well) and unnecessary fear. What a waste." An Ottawa Citizen editorial writer ("Bad medicine," July 29) was also unimpressed: "Take this conference with a grain of salt — which, in small quantities, will not cause cancer."

Many of the presentations dealt with the environmental causes of breast cancer: pollution, pesticides, plastics, food additives, water quality, radiation and the like. Narod says that even if action were taken on all potential environmental causes, the incidence of breast cancer might decline by 5% — at best. That's nothing to scoff at, he adds hastily, but "even without pesticides we'd still have a major problem."

Narod also notes that the conference raised some rational concerns about oral contraceptives, hormones in meat and milk, and other issues. "Bovine growth hormones concern me," he says. "They're biologically active in humans. They do influence cancer risk — the question is the degree of exposure through food additives."

Narod argues that research should concentrate on prevention, treatment and biology. "The problem with these conferences is they come across as more and more marginal, and therefore fewer scientists will submit [papers]," he says. "I think they will lose corporate sponsors and the public will get bored with the same message."

Organizers are already planning the next World Conference on Breast Cancer. Scotiabank was this year's main corporate sponsor.

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© 1999 Canadian Medical Association