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Many milestones in cancer research and discovery occur focusing mostly on secondary prevention and treatment of cancers. However, in recent periods there is increased interest in primary prevention and reduction of exposures to carcinogens.

Environmental Health Nursing Textbook

In 2017, the American Journal of Nursing announced Environmental Health in Nursing as a Book of the Year in Environmental Health. This textbook can be accessed free online and is divided into nine chapters. Many topics are discussed, such as toxic chemicals, climate change, environmental health nursing advocacy, and research.  Unit II – Harmful Environmental Exposures and Vulnerable Populations and Unit III – Environmental Health Sciences explain the effects of the environment on cancer prevalence in our society. Through widespread education, research, and policy development, cancer prevalence can be reduced in the United States.

Childhood Cancer: Cross Sector Strategies for Prevention Report

This critical resource, launched in 2020, addresses cancer risks and primary cancer prevention, focusing explicitly on childhood cancer, “Childhood Cancer: Cross-Sector Strategies for Prevention.” 

Children are more susceptible to cancer in contrast to adults. They pound-to-pound consume more food, water, air, and other environmental substances. Hazardous waste has been linked to the development of childhood cancers and other diseases such as neuro-development disorders. Despite the decrease in the death rate of childhood cancers, the incidence rate, the number of new cancers of childhood cancers per 100,000 children, is increasing. In the U.S. in 2019, cancer remains the leading cause of death by disease among children past infancy.

Researchers identified three different hazardous substances: pesticides, traffic-related air pollution, and paint/solvents contributing to cancer rates. One factor responsible for the development of childhood leukemia and brain cancers is pesticides. Children exposed to pesticides in pre and post-conception and from eating non-organic or unwashed produce. 

Two risk factors contribute to the development of childhood lymphoma. First is the mother's exposure during pregnancy. The second risk factor is exposure, especially low-income and minority children, to different air pollutants, such as car emissions and exposure to lead paint of outdated schools and playgrounds or hazardous chemicals in cleaning products. Strong evidence suggests the links between occurrences of most common childhood cancers such as brain tumors, leukemias, lymphomas, and different toxins in the air we breathe, the food we eat, and the environment we live in. This report serves to communicate research findings to encourage policy changes and bring awareness to the general public.

The report highlights that people of color, especially children, are affected more than the general population by high exposure to hazardous waste from manufacturing, agricultural facilities, or refineries. The proximity of those facilities often tights to low-income earners. Because of environmental injustice affecting significantly more vulnerable population groups, there is an urgent need to prioritize policy development to protect communities of color and low-income neighborhoods. Even though not all exposures lead to illnesses, addressing pollution and hazardous waste inequities opens an opportunity to improve the prevalence of childhood cancers and other diseases.

Joint Statement on Cancer Prevention

The second report released in September 2020 was the Joint Statement on Cancer Prevention, which calls for decisive action to reduce the cancer burden by addressing environmental risk factors. Cancer is a leading cause of death in children. In an estimate, 1 in 2 men and 1 in 3 women will be diagnosed with cancer at some point in their lives. Both in children and adults the prevalence of cancer rates continue to rise. The report provided examples of many chemicals that contribute to cancer and brings attention that despite many cancer reduction strides, the important optimal goal and focus need be on primary cancer prevention.

This goal can be achieved by bringing leaders in policy and health care, government, and industries to collaboratively take action on cancer prevention. The report proposed recommendations to address the prevalence of cancer in relation to many topics. The first topic is to teach providers and healthcare teams on how to screen people for toxin exposure and educate vulnerable populations and disproportionately exposed communities to voice their concerns and symptoms. The second recommendation is to strengthen laws and policies to prevent toxic substances from entering the market and eliminate them from the environment.  Another suggestion is to enhance research on the primary prevention of cancer. Considering that the nursing profession is one of the largest in health care, we as nurses have a voice to influence the future by advocating and speaking up for change.