Little Grey Rabbit's Historical Skepticism Blog

Holocaust blinkers or Himmler the budding cancer epidemiologist

Posted in Experiments, Miscellanous by littlegreyrabbit on February 6, 2011

Nothing can better illustrate the stultifying dead hand of Holocaust pieties than a paper published in late 2009 looking at differing cancer rates between European heritage Jews who emigrated before WW2 and those who emigrate after.  The complete journal article is here or there is a news article in Haaretz.

Cancer rates were compared between two groups of European born Israeli Jews: 258,048 who left Europe after the war and 57,496 who emigrated before or during the conflict.  Both groups have higher cancer rates than other Jewish (eg Sephardic) or non-Jewish (eg. Arab) ethnic groups.  The study concludes there is a 17% higher rate of cancer amongst those emigrating after WW2 and suggests malnutrition or “the traumas of the Holocaust” are responsible, the reported difference being strongest in the 1940-1945 group.

Sensibly the study excluded those who had emigrated after 1989 and so avoided the contaminating influence of the large influx from the Soviet Union.  One surprising fact about the demographics is there is not the dip in numbers of those born between 1940 and 1945 (highlighted in red) that I always assumed there would be.

Group Nonexposed group, No. (%) Exposed group, No. (%)
Men Women Men Women
Total 444 484 (100.0) 463 952 (100.0) 1 804 978 (100.0) 2 206 286 (100.0)
Birth cohort
1920–1924 158 052 (35.6) 161 125 (34.7) 397 834 (22.0) 519 343 (23.5)
1925–1929 127 525 (28.7) 132 929 (28.7) 342 575 (19.0) 492 743 (22.3)
1930–1934 102 040 (22.9) 112 007 (24.1) 326 174 (18.1) 387 166 (17.6)
1935–1939 39 129 (8.8) 40 244 (8.7) 338 512 (18.8) 377 733 (17.1)
1940–1945 17 738 (4.0) 17 647 (3.8) 399 883 (22.1) 429 301 (19.5)

The table is presenting “person-years” and how that relates to actual people, I am unsure.  But at roughly 21% of the exposed cohort being born in 1940 -1945, this might represent around 55 000 actual people (around one third of which according to nationality data are of Polish background).   This is especially surprising, as one would expect fertility and infant mortality to have taken an enormous hit during this period.  The least represented group is those born between 1930-1934, but the difference is not massive.  Previously I had always assume an almost total absence of the 1940-1945 cohort born in Europe but it appears I was mistaken.  Perhaps this might point to an absence of historical knowledge on the part of the authors, for there are two possible population reservoirs that might have contributed to maintaining a birthrate while a substantial proportion of those capable of bearing children were in sex-segregated labor camps.  The first is behind the Soviet lines in the areas of evacuation, the second is in Jewish reservations like Transnistria and perhaps others – of which we hear little.   In the case of Soviet evacuated Jews providing the bulk of this 1940-45 “exposed” cohort, this would render the analysis of this cohort showing the highest cancer risk suspect, because although food was short, it was not shorter for Jewish children than non-Jewish in Soviet areas.  Indeed, if we believe the Einsatzgruppen reports on intelligence out of Leningrad, it may be that sometimes slightly preferential treatment was available in terms of evacuation from that besieged city.  The other problem with reporting the 1940-1945 cohort as having the biggest difference in risk factor is due to the clamp down on the emigration there is only a very small control group (at approximately 4%, around 2000-2500 people).  This small group would also have been subjected to very strong selection biases, such as country of origin or socio-economic status.  Another factor might be the practise or irradiating child migrants for ringworm in the 1950s, the then approved treatment, although this is thought to have been applied more to Middle East and North African Jews.

As everyone knows, correlation is not causation and any number of factors might cause this difference between the two groups, possibilities which the authors did not consider

This brings us to Himmler’s dabblings cancer epidemiology which took place in Feb/March 1945 (the original german version is here as my translation skills are mediocre)

Dear Grawitz,
You know that in essence I rely with blind faith in reports.  You have reported a long time ago that  cancer does not exist in the concentration camps.  That was asserted  by a letter of the SS-Obergruppenfuehrers Keppler to me, which had discussed with you regarding testing a new drug.
This report is especially noteworthy, if one considers that according to the situation of 20.2.1945 there are 28 145 male and females prisoners of an age over 50 years, of which 4898 are over 60 years old.  As a consequence of the evacuation of Concentration camps Auschwitz, Monowitz, Gross-Rosen and Stutthof, these numbers admittedly are not complete.  Noteworthy is the picture of the robust health of these prisoners as regards cancer, whereby it would be interesting to determine what it is individuals then die of.  The deathrate in the camps is, as you know, on average in no way higher than outside the camps.
The investigatiions into the testing of new drugs on existing cancer patients continues, with which one could heal them. [translation uncertain here]
Now I am interested in the other side of the matter.  How many cancer patients are in the German population?  What percentage of the German population find themselves at the onset or other particular stage of cancer progression.
If one applies this rate to our prisoners, of which admittedly a signficant amount are foreigners, one would be able to calculate how many cancer sufferers among the 700 000 prisoners there must approximately be.  I assign you with the investigation of the causes, whereby prisoners do not get cancer.  I believe that we would thereby perform yet another great service to Science.
Heil Hitler
Yours H Himmler

What you make of Himmler’s claim that it is well known that death rates inside the camps circa February 1945 is not signicantly higher than death rates outside the camp is up to the individual reader.  But it may not be particularly surprising that cancer was not prevalent: if camp life did represent a Hobbsian world of survival then few would last long enough to proceed through the stages of cancer in the first place before succuming to another cause; alternatively if the Germans did wish to maintain a functioning work force, caloric restriction resulting in reduced cancer rates might be a sufficient explanation.  What it certainly indicates is there should be no expected correlation between camp exposure and cancer rates.  However, I would caution about putting too much weight on a single letter as evidence of a total absence of cancer.  Himmler tended towards crankery, and he may have just been being provided with a convenient excuse by officials to avoid research that they saw as pointless.

There was a paper published back in 2002 by Olle Johannson and Orjan Halberg called Cancer Trends in the 20th Century in the Journal of the Australian College of Nutritional and Environment Medicine (not highly ranked), which illustrates the width of view needed for seeking environmental causation to cancer.  Their belief is that the upsurge in cancer rates in the later half of the twentieth century can be traced electromagnetic waves and possibly the advent of things like AM or FM radio.  They use a number of approaches to draw this possible conclusion, including location on the body of cancerous lesions, but primarily their focus is on what they identify as a dramatic upsurge in cancer rates around 1960.  Although sometimes I wonder whether their might have been a selection bias in some of their data sets, I will present two indicative graphs from this paper.

Two distinct curves are identified in lung cancer deaths.  This seems to be repeated (although notice not all series are continuous) with a number of cancers [prostate, colon, melanoma, lung, bladder, breast]:

The exact mapping of the melanoma curve and the lung cancer curve is surprising when conventional wisdom is lung cancer is overwhelmingly linked to smoking.  What this might indicate is smoking alone is in most cases necessary, but not sufficient to cause lung cancer and an additional environmental factor is needed – smoking perhaps potentiating a weak point in the body’s defences.   It is also reasonably well known that despite being a nation of heavy smokers, the incidence of smoking-related lung cancer is relatively low in Japan.

In 2010 Halborg and Johannson expanded on this theory in 2010 in the Journal of Pathophysiology to include an explanation for side-preference in tumor location and the low cancer incidence in Japan by suggesting mattress spring coils might play a role in amplify the enviromental EM signal, while the popularity of springless futons in Japan mitigates against this.  For a summary one can see, in easily read blog form, Scientific America.

It is not a popular theory in the medical community, but it is innovative and, right or wrong, scientific progress depends on innovative thinking.   Because even if 9 out of 10 outside the box theories are wrong, the benefits that accrue from the one that is right outweighs the time spent dealing with the ones that were wrong.   More importantly in ought to be testable,  for superficially neat as this explanation is, it could easily fall apart on rigorous examination and be hiding other environmental based explanations.    An easy test would be to see if the melanoma/lung cancer correlation occurs in other countries.  Or if such an effect is latitude dependent – appearing in Scotland but attenuated in Queensland, Australia.

But so is the case with the Israeli study.  To my mind the authors did not even begin to consider other possibilities for their observed increase – such as different patterns of nationalities contributing to each cohort or different environmental exposures across “exposed” and “non-exposed’ groups.  Quite conceivably whatever causes or factors underlying the 1960s uptick that the Swedish researchers observed might have been more prevalent in Europe, stronger and longer, than there were in Israel.   So these two datasets would reflect a common underlying cause.  It seems an unfortunate waste of resources and opportunity to fritter away such a data-set to prove such a dreary Holocaust historical memory talking point.   Although the comments that I applied to the worthwhile nature of making a case for EM related environmental cause, equally apply to making a case for childhood nutrition related cause – regardless if one or both of these explanation turns out in the end to be false.

And finally, for what it is worth, although death from other causes or caloric restriction might be in themselves sufficient to explain a reported absence of cancer cases in the 700 000 camp inmates cohort – it is also worth noting there probably weren’t that many iron mattress springs floating around the camps either.

3 Responses

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  1. lkboker said, on February 8, 2011 at 7:27 pm

    It is a very interesting post and I enjoyed reading it. I am one of the Israeli paper’s authors, and would like to emphasis that we had NO PERSONAL DATA. The data used was aggregated, and no adjustments could be made except for age, sex and birth cohort. Therefore we continued our hypothesis testing in a case-control study which is being concluded now.
    The point re. different nationalities at the post end is of interest, and so is the hypothesis re.the cancer uptick in Europe in 1960. I would like to propose another explanation for that – most of Europe did suffer a certain degree of caloric deprivation throughout the war. Perhaps this fact is related to the observed uptick. At any rate, in 1960 most of both study subcohorts were already in Israel, not in Europe.
    AS for the observation of seeing no cancer cases in the camps – there must have been a huge selection bias – those too sick to work were not very likely to live in these camps and those at the beginning of the cancer process would have needed subtle diagnostic tools to be properly diagnosed – not very likely either. Thus the chances of finding prevalence cancer rates in the camps comparabble to those of the non Jewish general population are very thin.

  2. littlegreyrabbit said, on February 9, 2011 at 10:14 am

    I am suitable impressed by receiving a comment at all – as my email and post were something in the nature of a wind-up.

    In the end my personal view is the caloric theory won’t prove to be correct (but obviously that is just subjective). There are plenty of places in the world with periodic famine but don’t show higher cancer rates and I presume a control could be made with countries of similiar development stage but more secure food supply. For example, Ethiopia and Egypt. Or China (the Mao famines) versus Taiwan.

    Increasing cancer rate seems, in my view, to be a disease of development and not just a result of reducing deaths from other causes. So I think your study may have just caught some of the wake of this effect.

    I take your point about the selection bias in the camps, but even if there is a selection bias that doesn’t mean some effect couldn’t have been observed – although we may never be able to demonstrate it one way or other. The camps were not the same as the ghettos – food was survivable until the Germany began to fall apart.

    • lkboker said, on February 10, 2011 at 7:50 am

      I totally agree that caloric deprivation is not a likely explanation for the cancer epidemic now seen, and that cancer is basically a disease of more developed, wealthy societies.
      However, we proposed a different hypothesis – that a transient, unbalanced caloric deprivation which ends abruptly and is not life-long may be a risk factor for the disease, for different reasons which are partly supported by former research.
      As for your query re. cancer in countries like Ethiopia – well, to see an increase in cancer rate there you need to have a proper cancer registry. Plus, longevity. Becasue cancer is a disease of older age and if your chances of getting into old age are scarce, so are your chances of acquiring cancer. As for China, I know that there is an ongoing study now on health outcomes of the 1950′ famine, and one of the outcomes studied is cancer, which is in place, because the survivors are now reaching the “cancer age”.

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