Politics in the Wine Cellar
© by John Juergens
The latest assault to scientific integrity and our native intelligence was launched by the National Toxicology Program (NTP), which is part of the Department of Health and Human Services. The purpose of the NTP is to "coordinate the toxicology research and testing activities among the health related agencies within the Department and to provide information about potentially toxic chemicals to regulatory and research agencies and the public." All well and good, but the political winds blow with gale force through the NTP and other government agencies when it comes to alcohol and health issues.
Each year the NTP is required to produce an updated list of substances that its review panel has determined through "rigorous scientific evaluation" are known to cause cancer in humans. This list contains some pretty nasty stuff like dioxin, sulfuric acid fumes, and benzene, things you definitely want to stay away from. However, in the most recent list published on May 15, 2000, called the Report on Carcinogens -- 9th Edition, the NTP has listed consumption of alcoholic beverages as a known human carcinogen. That's one hell of a pronouncement considering the ubiquity of alcohol consumption within just about every culture for the last 8,000 years.
In its latest report the NTP states that consumption of alcoholic is "causally related to cancers of the mouth, pharynx, larynx, and esophagus," and it goes on to say that studies indicate that the risk is most pronounced among smokers and at the highest levels of consumption. The problem with this statement is that it needs a lot of qualification because the solid scientific evidence that the NTP is supposed to use in making such statements just is not there. And what they don't talk about in their report is the broad dissent from this statement within their own review panel.
Back in February 1999, I had an opportunity to review the preliminary findings of the NTP on this issue and to submit written testimony about those findings and the manner in which they reviewed the scientific literature to arrive at their conclusion that alcoholic beverages definitely cause cancer. I, along with many highly credentialed health scientists, was astounded at the lack of evidence to support this conclusion and the seriously flawed and incredibly sloppy way in which the review panel conducted its investigative deliberations.
In their preliminary report, the NTP stated they had found more than 800 research articles describing studies on the relationship between alcohol consumption and cancer. However, for some unexplained reason the NTP panel chose to review only 80 of those articles; that's just ten percent of the available information. In other words, they ignored 90 percent of the research data, including most of the more recently conducted studies that we have heard so much about. Furthermore, they randomly chose articles based only on the size of the study population without consideration for the quality and adequacy of how the studies were conducted. Some of the articles heavily relied on by the NTP to make its case had not even been peer reviewed, which is one of their own basic requirements in all substance evaluations for carcinogenicity.
It seems obvious to me that if you are trying to find the truth in any matter you would want to consider all of the evidence available so that you can have some degree of certainty in your conclusion. Neglecting ninety percent of that evidence practically guarantees you will miss something important.
The manner in which the NTP went about its review of the alcohol and cancer relationship doesn't even pass what I call the "straight-face test." It would be laughable if it weren't such a tragic distortion of the time-honored scientific investigative process. This is the worst kind of pseudo-science used to justify a forgone conclusion. If a student in a graduate research course presented conclusions based on such a study design as that used by the NTP, he or she without a doubt would get an "F" for the course.
I am not alone in this assessment. As I mentioned, others far more experienced in these matters than I also submitted testimony to this effect. Even some of the members of the review panel objected to their conclusion. One of the two lead reviewers argued that because most of the subjects in the studies cited by the NTP in support of their conclusion possessed so many other risk factors, including poor nutrition and personal hygiene, and viral infections, that it was impossible to separate out alcohol consumption as the lone causative agent.
The entire investigative process of the NTP on the issue of alcohol and cancer was a fiasco. Minutes of the review panel meetings document that they violated many of their own procedures for independent and comprehensive review of the scientific literature, and that there was rampant confusion within the panel. One panel member indicated that he didn't even really know what he was voting on at the end of the meeting. Requests for clarification and a more carefully worded conclusion were ignored by the panel chairman.
After following the bizarre course of the NTP review of alcohol for almost two years and studying the transcript of the review panel meeting, I am absolutely convinced that the agency and its review panel were under enormous political pressure to list alcohol as a known human carcinogen, even if it meant subverting the agency's normally high standards and established procedures. But I invite you to make your own judgment about this. One only has to access the transcript of the proceedings of the NTP review panel of Dec. 2, 1998 to verify my assertions. While that document should be readily available from the NTP, the flavor of the meeting can be obtained from the sanitized and abbreviated summary minutes, which can be found at the NTP website: http://ntp-server.niehs.nih.gov/htdocs/liason/mtgs.html.
When I read the final version of the NTP Report, it was amazingly similar to their preliminary report released prior to public testimony. It was obvious that they ignored the massive amount of testimony submitted by experts who urged a more thorough and careful review of the available data. The only thing that is certain from the NTP review process is that we still do not know the true risk, or even if there is any risk, of cancer from any level of alcohol consumption. Labeling not just alcohol, but the process of consuming of it - the choice of wording is interesting to note - as a known human carcinogen provides a strategic launch site for all sorts of future assaults by the many anti-alcohol groups that now stalk the halls of Congress.
The NTP final Report on Carcinogens is a tortured document that is peppered with inconsistencies and contradictions. Due to internal pressure they were forced to include the qualifying statement that the risk of cancer is the most pronounced among smokers and at the highest levels of consumption, in other words, among alcoholics, even though we don't know that for sure either. However, my fear is that this very important part of the report will get lost in the shuffle when the news media get hold of it. My bottom line on this matter is that I want to get two points across to the responsible wine, beer, and spirits consuming public: