Toward Cultural Oncology: The Evolutionary Information Dynamics of Cancer

'Racial' disparities among cancers, particularly of the breast and prostate, are something of a mystery. For the US, in the face of slavery and its sequelae, centuries of interbreeding has greatly leavened genetic differences between Blacks and Whites, but marked contrasts in disease prevalence and progression persist. Adjustment for socioeconomic status and lifestyle, while statistically accounting for much of the variance in breast cancer, only begs the question of ultimate causality. Here we propose a more basic biological explanation that extends the theory of immune cognition to include an elaborate tumor control mechanism constituting the principal selection pressure acting on pathologically mutating cell clones. The interplay between them occurs in the context of an embedding, highly structured, system of culturally-specific psychosocial stress. A rate distortion argument finds that larger system able to literally write an image of itself onto the disease process, in terms of enhanced risk behaviour, accelerated mutation rate, and depressed mutation control. The dynamics are analogous to punctuated equilibrium in simple evolutionary systems, accounting for the staged nature of disease progression. We conclude that 'social exposures' are, for human populations, far more than incidental cofactors in cancer etiology. Rather, they are part of the basic biology of the disorder. The aphorism that culture is as much a part of human biology as the enamel on our teeth appears literally true at a fundamental cellular level.