With the repeal of the 2009 Endangerment Finding–the conclusion that greenhouse gases like carbon dioxide and methane pose a threat to public health and welfare–the Environmental Protection Agency (EPA) embraces climate denial as official policy. It is a particular blow to cancer care. This decision will increase fossil fuel use and the cancer-causing environmental conditions they create. It will also reduce our ability to successfully treat cancer patients.
This decision ignores the life-threatening impacts of climate change that millions of Americans (and more around the world) face. The truth is that climate change is already damaging health in many ways. It is causing workers to miss work, disrupting businesses and essential clinical care, and increasing the cost of living. It is driving up the costs of health care and health insurance.
As a group of oncology health care providers concerned about the impacts of climate change on cancer rates, treatment and outcomes, Oncology Advocates United for Climate and Health-Int’l (OUCH International) is sharing our concerns with those working in health care and public health. We witness both living proof that cancer touches everyone and the toll that climate change takes on cancer patients and their families.
The extraction and burning of fossil fuels increases cancer risk
The International Agency for Research on Cancer classified outdoor air pollution–primarily from burning fossil fuels–as carcinogenic to humans. While smoking is the leading cause of lung cancer worldwide, 14% of all lung cancer deaths worldwide is attributed to air pollution. And air pollution worsens mortality from lung cancer even in people who have never smoked.
Air pollution contributes to increased rates of other cancers, including breast, colon, and head and neck cancers. Reliable epidemiologic evidence also links childhood leukemia to living close to fracking sites, probably due to poor air quality from the drilling and extraction operations.
The increasing number of wildfires and the resulting air pollution also affects mortality and morbidity. For example, air pollution from Canada’s recent wildfires spread beyond its borders and caused an estimated 70,000 deaths wordwide. And exposure to wildfire smoke following curative surgery worsens survival for lung cancer patients.
Climate change-related disasters disrupt cancer care
Climate-driven disasters like hurricanes and floods cost lives, threaten food and water safety, and displace people from their homes. They also have devastating consequences for patients with cancer. Cancer treatment is precisely calibrated and must follow carefully calculated schedules, sometimes consecutive daily treatments over several weeks, to achieve the best outcomes. Delays or interruptions due to natural disasters likely worsen survival for cancer patients.
Such disasters can also disrupt care at clinical facilities. Affected facilities may lose power and water, and incur damage to radiotherapy equipment, clinical facilities, and medical record systems. Skilled staff may be unable to report for work, and disasters can delay deliveries of critical medications and supplies. And disruptions to routine cancer screening facilities and programs mean missed chances for early identification of breast, colorectal, cervical and skin cancers.
Local climate disasters can have nationwide implications. Puerto Rico’s 2018 Hurricane Maria forced closure of factories manufacturing intravenous saline bags used for hydration and IV drug administration. For months, patients across the U.S. could not get access to IV saline, leading in turn to rationing of care, increased health care costs, and suboptimal treatment workarounds for cancer patients.
The dangers of climate pollution are established in science and law
The EPA must protect the American people from the pollution driving climate change. The 2009 Endangerment Finding was based on credible, peer-reviewed science. Using reliable information is essential to the Code of Public Health Ethics and to the Sphere Charter’s standards for humanitarian responses.
But the repeal decision was based on a report hastily commissioned and authored by known climate contrarians whose findings have been roundly debunked and rejected by the scientific community. Furthermore, the Administration systematically dismantled our capabilities to research climate and to make such evidence publicly available,
The repeal not only ignores the weight of scientific evidence but disregards the voices of the American people. In September 2025, the National Academy of Sciences issued a report to inform EPA’s deliberations. It supported the accuracy of the 2009 Endangerment Finding and reported even stronger evidence since 2009. Because of the strength of the evidence, the Endangerment Finding has survived multiple challenges in court.
Broad support for addressing climate change
More than 1,000 scientists, public health experts and economists recently warned EPA that climate change poses severe risks. It harms human health, contributes to a higher likelihood of extreme events, and takes an extraordinary economic toll. A consensus statement at this blog and similar statements from over 230 leading medical journals support these conclusions. And the EPA received more than 570,000 public comments in response to the proposed repeal of the Endangerment Finding. Notably, it has publicly released only 5.4% of the comments so far.
As cancer health care professionals who care deeply about our patients, OUCH International strongly opposes the rollback of the Endangerment Finding. It is a striking blow to cancer care. We decry the lack of scientific rigor and the lack of meaningful public engagement. And we call on EPA to engage with medical and public health experts to prioritize the well-being of millions. The stakes are simply too high for inaction.
Author informationKen KobayashiDr. Kobayashi is an accomplished oncologist, clinical pharmacologist, and senior global life sciences executive. He has a deep background as a clinician scientist, regulator, scientific diplomat and drug developer across the US, Europe, Latin America, and Japan/Asia. As a senior executive in top-tier pharmaceutical companies including Pfizer, Daiichi Sankyo, AstraZeneca, Janssen, and Novartis, he has successfully overseen the introduction of more than 28 investigational agents and been directly involved with 60 programs, including in the areas of signal transduction inhibitors, epigenetic modifiers, and inflammation/immunotherapy. His experience also includes roles at the National Cancer Institute and the Food and Drug Administration. He is active in the climate change advocacy space, especially as it intersects with cancer outcomes.
He is currently studying for a Master’s degree in Public Health at the University of California, Berkeley. He received his AB from Washington University, St. Louis, MO. his MD from Northwestern University Medical School, Chicago, IL, and trained in internal medicine at Northwestern Memorial Hospital and in medical oncology at the University of Chicago, Chicago IL. He now works in the biotech space and is President of Small Woods Biopharma Consulting, LLC.
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