CancerPreventive Medicine


Here’s something I didn’t know about! There is actually a subsidiary of the Department of Health and Human services that monitors cancer-causing agents. Called the National Toxicological Program, at varying intervals it produces a “congressionally-mandated, science-based, public health document” called the “Report on Carcinogens.” In this report, new substances found to have cancer-causing potential are announced.

On December 21, 2021 the 15th “Report on Carcinogens” was produced and released to the public; more about that below. The full list (found at is divided into two main categories, which are:

     1.  Substances Known to be Human Carcinogens

     2.  Substances Reasonably Anticipated to be Human Carcinogens

What is a Carcinogen? 

The dictionary defines carcinogen as any substance or agent that tends to produce a cancer!

The updated list contains 256 substances. The 15th Report added eight substances which are the following:

     Antimony Trioxide — a flame retardant for plastic and textile-based consumer prods.

     Six Haloacetic acids — by-products of water disinfectant treatments using chlorine

     Helicobacter pylori — a bacteria in contaminated drinking water, known to cause

          stomach ulcers and stomach cancer

Interestingly the list of “Known Substances” has only 63 (25%) items while the “Reasonably Anticipated List” has 193 (75%), the balance of 256. Of the three new substances, only Helicobacter pylori made the “Known” list. 

Some known carcinogens are:

     Alcoholic beverages—hepatocellular carcinoma



     Dyes—liver cancer, Leukemia

     Epstein-Barr virus—Lymphomas

     Estrogens—breast and uterine cancer

     Helicobacter pylori—gastric cancer

     HIV—Byrkitt’s lymphoma

     Silica—lung cancer

     Sunlight, Tanning beds—skin cancer

     Tamoxifen—uterine cancer

     Tobacco smoke—lung cancer, oral cancer

Reasonably Anticipated Substances are:


     Basic Red Dye

     Carbon Tetrachloride





     Diesel Exhaust particles

     Lead and Lead Compounds



     Nitrogen mustard




     Ultraviolet Radiation

Known Carcinogens are given more emphasis by physicians for obvious reasons. Having the full list helps physicians when making a diagnosis because they consider substances they may have forgotten, or were unaware, could cause a cancer. It forces us to look deeper and farther into the patient’s history and environment for the cause of an illness. “Cancer affects almost everyone’s life, either directly or indirectly… the identification of carcinogens is a key step in cancer prevention…” Having knowledge of these lists should make all physicians more aware of the more unusual circumstances where cancer can occur. 

The complete list can be found at this website: 

Reference:  Health Agencies Update “Substances added to List of Human Carcinogens” JAMA 2022 Feb 22;327(8):709.

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