Climate change: why oncologists need to get involved

So why do oncology physicians, scientists, and other cancer health care professionals need to get involved? It is because cancer is a very, very scary word, and, as oncology health professionals, we are trusted messengers. A survey reported in the 2018 Lancet Countdown reported that 49% of respondents rated their primary care doctor as people they have strong or moderate trust as sources of health impacts of climate change; only 8% indicated they strongly or moderately distrusted them [13]. As health care professionals, we have a duty and a responsibility to get the word out that their health is at risk. All citizens need to know that climate change is not just an environmental hazard, or a political or social concern, but that it is a health concern, and can affect whether they develop cancer, how they are treated for it and what their outcomes will be.

What can we, as oncology health professionals, do? In addition to serving as examples by changing our personal behavior (reducing our use of combustion engines; using clean renewable power, etc.), we can educate our patients and the public by speaking out to our community (letters to our local newspapers; community events, townhall meetings, etc); to our medical colleagues (e.g. Grand Rounds, seminars) and to our hospital administrators to reduce their carbon footprint. The U.S. health care sector is estimated to contribute 8% of all US pollution [14], and 27% of the global healthcare footprint, the highest in the world [15]. We can inform our professional societies of the impact their activities and meetings have on the climate through such carbon-intensive activities as professional meetings, including airline transportation, ground transportation, food services, meeting equipment and operations, and meeting materials [16, 17]. We can tell our leaders they have a responsibility to their constituents, their constituent’s children and grandchildren, and their nation and the world by using the ballot box. We can stress that climate change is a non-partisan issue – it will affect everyone regardless of gender, race, ethnicity, socioeconomic status, geographical location, and political or religious affiliation. We can urge our pharmaceutical partners to move to carbon neutral and conduct a life cycle analysis of the carbon impact of their products. We can expose the injustice to the poor and underserved populations and countries who contribute the least to climate change yet suffer disproportionately.

Can we do this when we are we are busy and overwhelmed? In the US, the physician burnout rate spiked to 63% in 2021 [18]. Given our clinical, research, teaching, and administrative responsibilities, we are all strapped for time. Our professional work is critical, but there remain a range of ways in which we can all contribute, each taking varying amounts of time commitment. One example is to advocate through others – e.g. non-profit organizations who are already organized to carry on such work. There are many out there advocating for climate change and health care; there are relatively few, however, who advocate specially for climate activism and cancer.

One such organization is an emerging group of oncology health professionals known as Oncologists United for Climate and Health. www.ouchforclimate.org Fig. 1. Unlike other professional cancer organizations, OUCH focuses only on the rapidly evolving health crisis. Although other professional cancer organizations also have developed policy statements or white papers regarding the impact of the climate on cancer, these organizations speak only for their members and have various other responsibilities to them. OUCH serves a unique need in which all oncology health care professionals can participate, regardless of their discipline, disease interest, specialty, locality, or whether they belong to another professional organization.

The objective of the group is to advance awareness, actions, and policies that mitigate the effects of climate change on cancer incidence, outcomes, and health equity. We educate oncology health care providers, stakeholders, and patients about the effects of climate change on their patients, practices, and communities; we engage and empower the oncology healthcare sector to expand climate action and education; and we advocate for climate change action through public policy. We do this through public testimony; by giving lectures and talks to medical and civic organizations; and working with medical and oncology related professional organizations to amplify our voices on the health and cancer consequences of climate change. We have written an open letter documenting the link between climate change and cancer, calling for a reduction in the burning of fossil fuels. It currently has been signed by cancer care providers (international physicians, scientists, nurses, pharmacists, and advocates) from 15 countries, including two professional organizations representing more than 700 members, and is attached to this paper. If you are interested in adding your name to the statement, please fill out this very brief form: OUCH’s climate & cancer sign-on.

We share the hope that collectively, we can turn the tide of climate change and the cancer-related risks that come with it.

Please join us.

Joan Schiller, MD