responsibility for their own health. The connection between diet and breast
cancer was an often-cited example of how life style affects health. By the
1990’s, however, a large literature on determinants of risk behaviors explored
the bases of ‘life style’ decisions and found them rooted in social and economic
processes (e.g. [11, 22, 30, 58, 59]).
Many of the risk behaviors associated with AIDS, drug abuse, and vi-
olence, were shown to be coping mechanisms for dealing with frustration,
pain, deprivation, humiliation, and danger (e.g. [7, 58, 59]). The particular
modes of coping spread, first between social networks and then within social
networks by branching processes [32]. Indeed, one of the classic studies of
drug use, The Heroin Epidemics, described all these contagious small-scale
processes early on [29]. Risk behaviors may explain part of the pattern in
hormonal cancers.
Such behaviors, however, may not totally explain population differentials
in hormonal cancer incidences and mortality rates.
We propose an approach that more fully integrates the biocultural pro-
cesses that shape the development of humans, their cancers, and differentials
in both their susceptibility and pathways of disease progression. We be-
gin with Nunney’s [37] evolutionary history of cancer, as opposed to more
conventional local evolutionary dynamic theories of tumorigenesis within an
organism (e.g. [8]). Nunney’s analysis suggests that in larger animals, whose
lifespans are proportional to about the 4/10 power of their cell count, preven-
tion of cancer in rapidly proliferating tissues becomes more difficult in pro-
portion to their size. Cancer control requires the development of additional
mechanisms and systems to address tumorigenesis as body size increases - a
synergistic effect of cell number and organism longevity.
As Nunney puts it [37],
“This pattern may represent a real barrier to the evolution of
large, long-lived animals and predicts that those that do evolve...
have recruited additional controls [over those of smaller animals]
to prevent cancer”.
Nunney’s work implies, in particular, that different tissues may have
evolved markedly different tumor control strategies. All of these, however,
are likely to be energetically expensive, permeated with different complex
signaling strategies, and subject to a multiplicity of reactions to signals. For
modern humans, large animals whose principal selective environment is other