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Mechanisms, proof, and unmet needs: the perspective of a cancer activist.

Cancer activists who participate with cancer researchers in shaping public health policy provide a different perspective on the question of breast cancer etiology. We place a higher priority on reducing women's exposure to suspected breast carcinogens than in debating the specific biochemical mechanisms by which these agents may operate. As the fruits of AIDS activism and antismoking campaigns illustrate, answers to mechanistic questions have not been and should not be the driving force behind public health policy. As such, cancer activists embrace a form of conservatism that advocates prudence in the face of exposure to estrogenic and other endocrine-disrupting chemicals. This perspective stands in contrast to scientific conservatism, which directs its caution toward the issue of proof. Unmet needs for cancer activists refer not so much to data gaps as to the failure to eliminate ongoing cancer hazards. For this author and activist, unmet needs include ending women's continued exposure to such common estrogenic compounds as detergents, triazine herbicides, plastics, and polychlorinated biphenyls.