Written by, Mike Gill
What the new designation of processed meats as a group 1 carcinogen means to you.
A few weeks back the International Agency for Research on Cancer officially designated processed meats as a group 1 carcinogen and all red meats as a group 2a carcinogen. The predictably absurd overreaction in the media that followed has been called “Bacongate”. As far as I know, the predictably absurd overreaction to the first overreaction has not yet been named. This article will break down what it means to be a group 1 carcinogen, the risk to you the reader and what to look for in the future.
As a side note, can we as a society not do better than “Bacon-gate”? I propose Colorectal Roulette (trademark pending).
Press-releases and the state of internet writing
When the IARC issued their press release documenting the new designations of meats as carcinogenic or potentially carcinogenic, it was done so in language familiar to public health and medical personnel. In very dry, scientific writing, they explain that consuming 50g of processed meats per day can increase the risk of colorectal cancer by 18%. To one not familiar with the language of public health, this is a severe sounding jump in cancer risk. Looking behind the numbers paints a different picture, which I will clarify later.
When the press release was interpreted through the internet, the results were predictably apocalyptic. Why predictably? Because making money on the internet is all about selling advertising, and advertising sales is all about number of hits on your website. “Bacon Will Kill You!” will generate hits in a way that “Bacon marginally increases your risk of colorectal cancer, if you eat 50 grams per day” will not (especially when Americans don’t know what a gram is, unless it’s in relation to marijuana). And so we had overreaction number one.
Directly following that overreaction, we had a more interesting (to me at least) overreaction. This one comprised the clarification that meat wasn’t as dangerous as earlier articles had led us to believe. This part was true. The overreaction was more subtle, in that it pointed out that meat is not as dangerous as cigarettes or asbestos, but with little to say beyond that other than “don’t worry about it.” The overreaction was in not pointing out that the IARC placing processed meats on the list of things that are known carcinogens is a big deal, regardless of the relatively low risk.
Scientific Method and the difficulty of proof
There is a belief among people who are not a part of the scientific community that until something is proven, everybody is entitled to beliefs; without proof, there are only opinions. The word “theory” means little more than idea and carries no weight. Within the scientific community there is a very different picture. The concept of proof is seen as close to impossible. A “theory” can only be disproven. Once it has stood for long enough (which is always up for debate), it can be generally accepted as proven, though it is understood that the scientific method allows no room for actual proof.
With public health and poisons, gleaning proof is especially difficult. So much so that cigarette company executives may continue to claim that cigarettes haven’t been proven to be carcinogens (they are correct, by the way). To prove it, we would need data from several reliable, controlled studies. The only form of study that can give us reliable information is our standard double-blind, controlled study. Even then, consensus is only reached where enough of these studies give the same result. Herein lies the rub: it is unethical to conduct studies where participants are given something which might be damaging to their health. Cigarettes, asbestos, and processed meats can never be studied in this way, nor can anything else we suspect to be harmful.
Without double-blind studies, we are forced to rely on approximates. Animal testing is available, but often inaccurate, as animal systems differ from ours. Test tube studies allow us to see chemical reactions, but they do so in a way that separates them from the complete system. We can gauge a chemical reaction, but not its effect on the overall whole (which is the important consideration). Population studies focus on number crunching of real world populations, their health status and their lifestyles. These studies are appropriate, but it is impossible to filter out all of the variables, allowing the data to be read in very different ways by different experts. For anything to make it onto the list of group 1 carcinogens, there needs to be mountains of data to suggest that the chemical is carcinogenic. More specifically, there has to be enough data for an agency of 22 international experts whose job it is to find holes in scientific theories to all agree that an item almost certainly causes cancer. This mountain of data must stand long enough and strong enough for the experts to conclude that the item being carcinogenic is the only logical explanation. In the scientific world, where almost everything operates in probabilities, any time something common becomes a group 1 carcinogen, it is a big deal.
Relative Risk- What the numbers mean to you
The key numbers in the press release were 18% increased risk and 50g per day of processed meats. What does that really mean? What wasn’t as clear as it could have been to the general public was that the risk increase listed is relative. The rate of colorectal cancer for the general public is about 1%. So, if you eat 50g per day of processed meats, your chance of getting that kind of cancer jumps to 1.2%. Not really the stuff of apocalypse, right? But how much processed meat do you eat? According the report, the risk continues to rise along with the amount you consume. A hot dog is about 50g, so one of those every day could jump your risk up to 1.2%. While you may not be eating a hot dog every day (I’m hoping that you aren’t), there are many other ways to keep your numbers up: ham, bacon, Arby's, spam, beef jerky, head cheese, Slim Jims, “potted meat food product”, Hot Mama pickled sausages, billatong, pastrami, Subway sandwiches, anything produced by Oscar Meyer or Hormel, and almost anything at a Midwestern tailgate party. If your numbers hit 250g per day, congratulations! You’ve officially doubled your likelihood of colorectal cancer, and made the writer of this article throw up in his mouth a little bit. You may want to consider a pilgrimage to Katz’s Deli in New York City. Still, the chances of you getting the disease are only 2%.
This type of risk analysis is best suited for analyzing populations, not specific people. It is a public health issue, more than a medical issue, which is how it was presented by the IARC. When looking at it in this light, the importance becomes clear. A tiny jump in risk, applied over a large population allows us to see the numbers add up. A good example of that is here. The chart is the key part, showing that if nobody in the UK ate processed meats, there would be 8800 less cases of colorectal cancer each year. To put this in perspective, here in the US sweeping legislative changes appear to be on the way due to a record number of measles cases in 2015. The number? 189 cases. While I can appreciate that kids evoke emotional responses in a way that adults don’t, would you rather your child get measles or colorectal cancer?
While nobody is suggesting that everybody quit eating processed meats entirely, it is the job of public administrators to use this type of data in creating policy. Things like institutional meal planning and subsidies, to name a few, have been shown to increase or decrease consumption of harmful and healthful items. These tools can and should be used as a way of decreasing our exposure to any carcinogens.
What to look for in the future
This is where I dust off my crystal ball, straighten out my scrying sticks and imbibe my mystical ham-loaf, all so I can see into the future. Hmmm…. The view is dim, obscured as is from a thick layer of bacon grease. I guess I’ll have to consult the past as a guide.
With cigarettes, there was no sudden realization of “holy @#%#, these are killing us!”. There was a slow progression from “these might be harmful” to “these might be fatal” to “these increase the risk of cancer by 2500%”. I would expect a similar progression, though not nearly one as dramatic as cigarette smoking, with processed meats. Now that it is accepted that they cause cancer, I would expect studies to start honing in on what exact part of processing is causing the rise in risk. This is strange, by the way. Sausage, bacon, jerkies, and many other types of preserved meats have been around for millennia. Why is it that we are now seeing a rise in these types of cancer? What particular change has been made to account for the jump? It would be easy enough to simply say “we’ve been eating these forever, there’s no need to change anything”. But the numbers are there, denying this with utter disregard for our nostalgia. Moving forward, expect to see the focus of studies narrow from a group as broad as “processed meats” to something more specific.
You may also expect public policy to slowly change, in an attempt to shift us out of culturally supported lifestyles which are making us sick. Change will be slow, as it was with cigarettes, but it will begin. It won’t be as sweeping as cigarettes; your favorite bar or restaurant won’t start having bacon and non-bacon sections, nor will you be forced to shiver outside, ostracized and marginalized, while you take your 15 minute “ham break”. In all likelihood, change will be so slow as to not be noticable until we look back on it years later.
In the meantime, you have a choice. You may choose to cut down on your processed meats, or you may play Colorectal Roulette. The risk in the game is pretty low; you probably won’t get colorectal cancer (though you may end up with any of the other numerous complications associated with diets heavy in salt, fat and meat). The reward is the ability to enjoy ham, sausage, spam, jerky and any other processed meats. Whether the reward is worth the risk is a decision for you and you alone.
Michael Gill is a Certified Nutritional Professional and Licensed Massage Therapist, with 14 years of experience in the natural health field. He holds a B.S. in Health Sciences from the Portland State University, School of Public Health. He has a practice in downtown Portland, and has a black belt in Poekoelan Tjiminde Tulen.