CANCER: DISEASE OF CIVILIZATION?

By Vilhjalmur Stefansson. New York: Hilland Wang, 1960. 180 pp. $3.95.

Although the part played by the environment in the cause of cancer has long been under scientific scrutiny, only in the last half century has the subject been brought into sharp focus. The external, geographical factors are reasonably well documented; internal stimulations, glandular and nutritional, are less well known. A study of individuals, particularly those living in restricted areas outside the frontiers of civilization, indicate that primitive peoples, such as some Eskimos, are relatively free from cancer as long as they retain their native way of life. The most authentic evidence regarding cancer-free populations comes from medical missionaries, the captains of whaling ships, who usually acted in the late-nine-teenth century as their own ship doctor, and qualified physicians serving as surgeons to polar or inland expeditions. Similar conditions to those found among some Eskimos have been disclosed in a study of the inhabitants of more moderate climates, among the Hunzas in northern India and in the natives of Brazil, Ecuador, and elsewhere. The facts about the Eskimos are partially based on Stefansson's personal experience of living with them under Stone Age conditions in a remote frontier settlement.

The peoples, moreover, most free from cancer live on a diet of fresh and raw foods, meat, fish, or vegetable, served after a minimum of processing. That such a diet prevents cancer is far from proven, but the anthropological evidence, now carefully collected by Stefansson, is at least suggestive that such may be the case, although the data does not satisfy exacting statistical requirements. Quantitative studies, which would be highly desirable, are not possible, under the circumstances, but such observations as we have, as pointed out by Rene Dubos in his Introduction, "raise intriguing questions as to the effect of environment and customs on the' incidence of disease." Some of these questions may find answers when more thorough medical surveys are undertaken to detect the possibility of undisclosed types of cancer and follow-up studies of individual cases are carried out. Stefansson has pointed the way for research in the near future by his provocative book. At present he rightfully leaves the question of civilization as an etiological factor in cancer an open one.