Accomplishments in Cancer Epidemiology

In his chapter “Accomplishments in Cancer Epidemiology,” Dr. MacMahon summarizes the history of the discipline, particularly the epidemiologic evidence on cigarette smoking, ionizing radiation, occupation, the physical and microbiologic environments, the reproductive experience of women, alcohol, and iatrogenic exposures as their bear on cancer risk in humans. Ionizing radiation as a cause of leukemia and cancer of the skin, breast, lung, and thyroid is discussed in detail, as well as liver cancer and myelogenous leukemia following exposure to the X-ray contrast medium thorotrast. Important occupational carcinogens include arsenic (lung cancer, bladder cancer), asbestos (lung cancer and mesothelioma), benzene (acute myeloid leukemia), chemical dyes (bladder cancer), chromium (lung cancer), nickel (nasal cancer), and vinyl chloride (angiosarcoma in the liver). The chapter ends with a broader overview of the other environmental causes of cancers that are reviewed in detail in the site-specific chapters.