Commentary: Epidemiology on the side of the angels

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Abstract
Hurtig and San Sebastián1 have examined cancer incidence rates in a region of the Amazon basin of Ecuador and ostensibly found higher cancer rates in the area closer to oil extraction sites than in the area further away; they concluded that this should lead to the establishment of systems of environmental monitoring and control, and of cancer surveillance. The conduct and publishing of this work raise several issues, of which I will comment on three: the strength of evidence that this study affords, the replicability of this study; and the public health recommendations that can be made.