Assuming the Conclusions: Risk Assessment in the Development of Cancer Policy


This article examines the development of generic cancer risk assessment guidelines, or cancer policy, from 1976-1984. Risk assessment is considered the objective determination of the degree of risk from a substance. Risk management is the subjective determination of acceptable risk. However, uncertainties in the scientific foundations of cancer policy necessitate risk assessment inference choices, for example, over appropriate dose-response extrapolation models. Those choices are only partially scientific; they are also partially political. There is, as a result, an inevitable mixture of facts and values in cancer policy. The article explores ten inference controversies and evaluates how nine cancer policy documents resolved those controversies. It then traces the course of cancer policy development, showing how the Carter and Reagan administrations produced policies with difference emphases and considers several major challenges to cancer policy. The article then provides several justifications for cancer policy in the face of those challenges. It suggests, in the conclusion, that the controversies are unlikely to be resolved by science alone and politics will continue to influence the content of cancer policies.


Political Science

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Politics and the Life Sciences