IARC is recruiting a new Director: time to bring back scientific rigor

In November 2017, the International Agency for Research on Cancer (IARC, or Centre international de recherche sur le cancer in the original French) announced it is looking for a new Director. The posting specifies that the appointment will be made in May 2018 and that candidates have until mid-February to apply. The new hire will be appointed for a five year term and will replace outgoing Director Christopher Wild, who has held the job since 2009.

For an organisation with a controversial track record, this is a critical moment for reform.

The Lyon-based agency, which reports directly to the World Health Organisation, is a prime example of how science is no longer reserved “for scientists”, but has become an arena where experts, politicians, lawyers, the media and ultimately, public opinion are all involved. Only by looking at all these many factors can we begin to understand scientific controversies and how they come into being.

As I have previously shown in my epistemological thesis, it is important to distinguish between controversies and polemics. The former is defined as a disagreement between experts in the same field, which arise when they differ on the interpretation of a specific scientific fact. Polemics, however, spring from reasons outside the world of science and often consist of opponents attacking each other by resorting to ad hominem arguments. In the case of polemics, participants may, for example, accuse each other of not declaring conflicts of interest, of belonging to different political ideologies, of failing to comply with peer review processes, or of any type of argument that moves the debate away from the scientific sphere.

As a semi public organisation, it is clear that IARC has been responsible for a torrent of polemics: for example if I type “CIRC + coffee” into google.fr, the first hit I get is a press release from the organisation’s website evaluating the drinking “of coffee, maté, and very hot beverages” – and within the document, in bold type, “The Working Group found no conclusive evidence for a carcinogenic effect of drinking coffee. However, the experts did find that drinking very hot beverages probably causes cancer of the oesophagus in humans. No conclusive evidence was found for drinking maté at temperatures that are not very hot. “

But that decisive statement conceals a complicated history: it’s worth remembering that coffee had been classified by IARC as a carcinogen for over 25 years. However, the 23 independent experts from the WHO-affiliated organisation, whose task it is to maintain a list of substances classified according to their carcinogenic potential, reviewed their position in 2016, after an analysis of more than 1000 studies carried out in humans and animals did not provide conclusive evidence. Interestingly, the European Food Safety Authority (EFSA) announced back in 2015 that coffee “does not present any safety concerns for healthy individuals.” Albeit belatedly, IARC ended up agreeing with the European organisation.

It’s also important to note that IARC does not actually produce any studies itself, as a research center or a regulatory agency would do. Instead, it selects and compiles previously published studies and issues an opinion that has no regulatory value. Other than claiming coffee is a carcinogen, IARC is best known to the general public for its Monographs linking exposure to mobile phone radiation, meat and more recently, glyphosate, to various types of cancer.

IARC classifies substances into five groups: “carcinogens” (Group 1), “probable carcinogens” (Group 2A), “possible carcinogens” (Group 2B), “unclassifiable” (Group 3), and “probably not carcinogenic”. To go to the previous distinction between controversies and polemics, a controversy-type debate can only take place between the experts who, after carefully perusing the scientific literature, are likely to think in terms of the falsifiability of a finding. It was in this way that the working group realised that coffee’s supposed carcinogenic effect was not attributable to the beverage itself but to the burns caused by drinking very hot drinks – in an about-face reminiscent of Carl Hempel’s description of Ignaz Semmelweis’ research into puerperal fever.

As one might suspect, it is often difficult to contain the debate within the scientific sphere, before it quickly spills over into the realm of polemics and public controversies. A cursory look over the way IARC’s red meat Monograph was covered is enough to convince anyone that most journalists decided to abandon objectivity for the sake of inking splashy headlines that rile the public and sell copy in the process.

Between Le Monde, which confined itself to reporting the paper by accurately titling their piece “Red meat is “probably” carcinogenic “, and Europe 1 that blared: “Meat and cancer: the shock WHO report“, there is a world of possibilities for the reader’s imagination to run riot in. And you need only look at “Google suggests^[1] ” to see the impact that IARC’s advice has had on public opinion. The first two phrases suggested by the algorithm when we enter the word meat, are “carcinogenic ” and “causes cancer “.

But what did the WHO have to say on the topic? Its website actually states that, “An international advisory committee that met in 2014 recommended red meat and processed meat as high priorities for evaluation by the IARC Monographs Programme. This recommendation was based on epidemiological studies suggesting that small increases in the risk of several cancers may be associated with high consumption of red meat or processed meat. Although these risks are small, they could be important for public health because many people worldwide eat meat and meat consumption is increasing in low- and middle-income countries (LMICs).”

While the risks are small, since the topic is particularly sensitive, the media flurry has dramatically altered public opinion.

Another controversial topic has been the financing of IARC – so much so that the U.S. Congress stepped in the debate. In 2016, in a letter to the Director of the National Institutes of Health (NIH), the chairman of the House Oversight and Government Reform Committee, Jason Chaffetz, mentioned IARC’s “history of controversies, retractions and inconsistencies ” He also wondered why the NIH, which has a yearly budget of $33 billion (€29.6 billion) continues to fund it.

These exchanges demonstrate how far we have strayed from the realm of science and how far we’ve veered into the world of political and legal influence, where controversy becomes polemic. IARC has lost ground on scientific discourse and its capacity to concentrate on analysis of the facts. Due to an extraordinary amount of non-scientific ideas, which have clouded the debate, IARC has become a political tool that awards gold stars and brownie points – and whose first victim is the consumer who doesn’t know which way to turn. The consequences shouldn’t be understated, as IARC plays a pivotal role in shaping public opinion.

Against this backdrop, let’s hope that IARC will choose in May a representative who will be able to keep the debate on a firm scientific footing and that will spare us the media flurries of the past.

^[1] This search engine functionality lists which ideas are most associated with a given subject by Internet users performing searches.

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