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"By denying scientific principles, one may maintain any paradox." – Galileo Galilei

If Real Change is to Occur, IARC Must Review Its Preamble Under Incoming Director’s Leadership

Just weeks before Dr. Elisabete Weiderpass is set to officially take the reins as the new director of the International Agency for Research on Cancer (IARC), the agency will update its Preamble to the IARC Monographs, a document that establishes the general principles and procedures used in developing Monographs. While an update to the Preamble is crucial and well overdue, the decision to conduct an update prior to Dr. Weiderpass assuming her new role is troubling and suggests that the agency will be maintaining the status quo rather than implementing substantial and comprehensive reforms to its embattled Monographs Program.

In mid-June, the Campaign for Accuracy in Public Health Research (CAPHR) Coalition sent a letter to Dr. Christopher Wild, IARC’s outgoing director, expressing concern about the organization’s impending update of its Preamble to the IARC Monographs. Considering the long-lasting implications that this will have for not only the Monographs Program but also IARC as a whole, it is imperative that the revision process is conducted under Dr. Weiderpass’ leadership.

Concerns Abound

While IARC has always been a source of debate in the scientific community, it was under Dr. Wild’s leadership that the agency firmly established itself as a controversial organization, as its systemic use of questionable science has led to widespread confusion from consumers and criticism and distrust from regulatory bodies. As members of the U.S. House of Representatives stated in a letter to Dr. Weiderpass earlier in June, “…the Monograph Programme operated under Director Christopher Wild was an affront to scientific integrity and bred distrust and confusion in the marketplace and amongst government regulators.”

Considering the multitude of controversies that occurred under Dr. Wild’s leadership and his refusal to address any of the Monographs Program’s serious faults, it is very concerning that one of his last responsibilities as director will be to update the Preamble, firmly establishing the trajectory to which the Monographs Program will adhere for many years to come.

What Needs to Happen?

In order for IARC to re-establish itself as a trusted scientific authority, as opposed to an increasingly distrusted agency, the first step would be to defer updating the Monographs Preamble until after Dr. Weiderpass assumes control. It is only appropriate that she bear the responsibility of revising a document that could come to define her tenure as IARC’s director. Furthermore, comprehensive and impactful reforms to the Monographs Preamble are necessary to right the ship. Under Dr. Wild’s authority, it seems unlikely that crucial and necessary actions will be taken. These would include (but is not limited to) evaluating the procedures by which the Monographs Program:

  • Identifies and reviews relevant studies for quality and reliability of methods, data, analyses and findings;
  • Integrates studies of differing quality and dissimilar findings within a given line of evidence and across lines of evidence, including studies which show no biologically significant findings;
  • Ensures transparency and reproducibility in integrating mechanistic studies to arrive at conclusions as level of evidence being high, moderate or low;
  • Engages stakeholders and outside experts, and evaluates conflicts of interest;
  • Ensures working groups are composed of qualified scientists with a range of expertise and perspectives;
  • Follows best practices for peer review; and
  • Communicates findings with appropriate context.

If IARC is going to effect true, concrete change to its Monographs Program, it must reform the Preamble from the top to the bottom. However, while there are many policy changes that need to take place to achieve positive results, the starting point of this process would be that Dr. Weiderpass is the person responsible for overseeing the proposed update.