The Epidemiology of Cancer. From the Viewpoint of the Health Officer

Our plain-English summary of The Epidemiology of Cancer. From the Viewpoint of the Health Officer, by M.L. Levin (American Journal of Public Health and the Nation's Health, 1944).

The study

• Author: M.L. Levin
• Journal: American Journal of Public Health and the Nation's Health
• Published: 1944;34(6):611-20
• Read it: PubMed · Publisher · Free full text

In plain English

This 1944 article was a talk given to health officers at an American Public Health Association meeting. In it the author, from the New York State Department of Health, reviewed what was then known about cancer in people. It was not a study of asbestos. Asbestos appeared only once, in a list of agents the author described as known to cause cancer in man, where it was given as "possibly asbestos." The review cited a survey listing 146 occupations in the United States with possible exposure to known cancer-causing agents. It also cited an estimate by Hueper of 8,000 to 9,000 occupational cancer cases reported worldwide, about 400 of them from the United States. The author named industrial management's reluctance to release information as one reason reported cases were few. In upstate New York from 1931 to 1941, age-standardized cancer mortality rose 10 per cent in males and fell 6 per cent in females. Mortality from cancer of the lungs and other respiratory organs rose threefold in males. The author wrote that continued medical observation of exposed workers, even after they left that employment, was clearly indicated.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review presented as a talk to the Health Officers Section of the American Public Health Association; no original study of asbestos
• Who was studied: No study population of its own. The author reviewed published data on cancer in people, mainly from England and Wales and the United States, and reported a comparison of cancer mortality in upstate New York from 1931 to 1941.
• Exposure: Cancer-causing agents in general (arsenic, tar, pitch, paraffin, petroleum oils, benzol, aniline dye compounds, radiation and others). Asbestos was mentioned only as a possible cause, in a single list.
• Main results:
  • The author listed asbestos, with the qualifier "possibly", among the substances or agents known to cause cancer in man, together with nickel carbonyl and chromates.
  • A cited survey (Dublin and Vane) listed 146 occupations in the United States in which exposure to known cancer-causing agents may occur.
  • Hueper estimated 8,000 to 9,000 occupational cancer cases reported in the world literature, about 400 of them from the United States.
  • For occupational cancers, the author wrote that the time from exposure to tumor may be as long as 30 years, averaging about 16 years for some agents.
  • In upstate New York from 1931 to 1941, age-standardized cancer mortality increased 10 per cent in males and decreased 6 per cent in females.
  • Over the same upstate New York period, mortality from cancer of the lungs and other respiratory organs increased threefold in males but only slightly in females.
• The authors' conclusion: The author concluded that continued medical observation of workers exposed to cancer-causing agents, even after they left that employment, was clearly indicated. The author also concluded that the factors discussed pointed to possible public health measures aimed at groups with apparently high cancer mortality.
• Limitations the authors state:
  • The author stated that the role of the known cancer-causing agents in the vast majority of human cancers was at that time unknown.
  • The author noted that occupational cancers are likely under-reported, partly because industrial management is reluctant to release information.
  • The author stated that a more complete review of differences in cancer mortality was outside the scope of the paper.

Topics

Medical terms in this study, explained in our Lexicon: Epidemiology.

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