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Biomedical subjects

R Doll

Publications and source records attributed to R Doll.

At least 109 records · Page 6Linked to original sources
PubMed1991

Urban and rural factors in the aetiology of cancer.

The incidence of cancer, or the mortality attributed to it, has been compared in urban and rural residents in 13 populations. In each case, the incidence (or mortality) has been higher in the urban areas in each sex, the ratios varying from a minimum of 1.03 to 1 in men in Japan to 1.63 to 1 in men in Denmark. Examination of 26 separate types of cancer showed that 23 tended to be more common in towns, 1 (myeloma) to be evenly distributed, and 2 (cancers of the lip and eye) to be more common in the countryside. The urban excess was greatest for cancers of the bladder, larynx, liver, lung, mouth and pharynx, and oesophagus, and least for leukaemia and non-Hodgkin's lymphoma. It is concluded that differences in personal behaviour (cigarette smoking, alcohol consumption, sexual promiscuity, exposure to ultraviolet light, type of diet, and family size) are the principal factors responsible for the urban excess. Other factors include general atmospheric pollution, occupational hazards, genetic differences in susceptibility, and artefacts of diagnosis and recording. The rural excess was marked for cancer of the lip in both sexes, but less marked and clearly evident only in men for cancer of the eye. Three-quarters of eye cancers are melanomas and the excess incidence in rural areas provides some weak support for the idea that exposure to sunlight contributes to the production of the disease.

Denmark↗
PubMed1991

Completeness of follow up in a cohort study of mortality using the United Kingdom National Health Service Central Registers and records held by the Department of Social Security.

STUDY OBJECTIVE: The aim was to evaluate and improve the completeness of follow up in a cohort study of mortality carried out using the UK National Health Service (NHS) Central Registers. SETTING: This was a follow up study of UK servicemen who served abroad in the 1950s and 1960s, including those who participated in the UK atmospheric nuclear weapon tests and experimental programmes. DESIGN: Details of men for whom follow up achieved using the NHS Central Registers was unsatisfactory were submitted to the Department of Social Security (DSS) for tracing, as were details of men born before 1916 and reported by the NHS Central Registers as currently registered with a general practitioner, and a 1% sample of remaining men born in or after 1916. MEASUREMENTS AND MAIN RESULTS: The additional follow up increased the number of deaths fully identified in the cohort by 6.5%. Mortality among those untraced on the NHS Central Registers was substantially greater than in the cohort as a whole (10.2% v 6.9%). Among those reported by the NHS Central Registers as not currently registered with a general practitioner, 2.7% were found to have died, as were 1.1% of men born before 1916 and currently reported to be registered with a general practitioner. As expected there was clear evidence that information about emigrations supplied by both the NHS Central Registers and DSS is far from complete. CONCLUSION: Standardised mortality ratios based on follow up via the NHS Central Registers alone are likely to be somewhat low, and this should be borne in mind when interpreting the data.

Adult↗
PubMed1990

Time from infection with HIV to onset of AIDS in patients with haemophilia in the UK.

The two-stage parametric regression model of Brookmeyer and Goedert has been adapted and fitted to data on the development of AIDS in haemophiliacs in the UK who are seropositive for HIV. The risk of developing AIDS by a given time following seroconversion increases with increasing age at seroconversion. It is likely that the risk increases smoothly with age, although the data have been analysed in three age categories, and it is estimated that by seven years after seroconversion 6 per cent of patients aged under 25 at seroconversion, 20 per cent of those aged 25-44 and 34 per cent of those aged 45 or more have developed AIDS. For a given age at seroconversion the annual risk of developing AIDS increases with increasing time after seroconversion, and at seven years the annual risks of developing AIDS during the next year in the three age groups are estimated to be 2 per cent for those aged less than 25 at seroconversion, and 10 and 11 per cent respectively for those aged 25-44 and 45 or more.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Mortality among United Kingdom servicemen who served abroad in the 1950s and 1960s.

The Registrar General's decennial supplements on occupational mortality provide only limited information on mortality in the armed forces in the United Kingdom. Mortality has therefore been studied among a group of 30,619 United Kingdom servicemen who served abroad in tropical or desert areas in the 1950s and 1960s, and who remained in the services for a total of at least five years. Mortality from all causes of death, all neoplasms, and all other known non-violent causes was lower than that expected from rates for all men in England and Wales, whereas mortality from accidents and violence was raised. These differences remained after adjustment for social class, affected both officers and other ranks, and had not disappeared even after the men had been followed up for at least 20 years. When mortality from 20 specific cancers and 10 other disease groups was examined there were significant excesses for cancers of the oesophagus (standardised mortality ratio (SMR) = 146; p = 0.03) and prostate (SMR = 156; p = 0.03), and significant deficits for cancers of the lung (SMR = 73; p less than 0.001), stomach (SMR = 66; p = 0.002), bladder (SMR = 53; p = 0.02), other specified neoplasms (SMR = 48; p = 0.001), coronary heart disease (SMR = 76; p less than 0.001), bronchitis, emphysema, and chronic obstructive lung disease (SMR = 42; p less than 0.001), and for five further groups of diseases unrelated to smoking or alcohol. Examination of mortality in each of the three services separately identified two specific hazards in the Royal Navy; seven deaths from mesothelioma occurred compared with less than 2.06 expected (p less than 0.005), and there was also an excess of neoplasms and of other diseases associated with alcohol (SMRs of 181 and 229; p = 0.002 and less than 0.001). Mortality from smoking related diseases other than those associated with alcohol was low in all three services, particularly among officers.

Accidents↗
PubMed1990

Lifestyle: an overview.

Lifestyle is a convenient portmanteau term which, in relation to the causes of cancer, has come to mean all aspects of the way people behave, whether determined voluntarily or imposed by economic, cultural, or geographic circumstances, including reproduction but arbitrarily excluding occupation. Modification of lifestyle seems to be able to reduce the age-specific risk of cancer by about four fifths in many communities. This does not imply that the control of other factors could not reduce the risk by more than a fifth, as the chain of causation can be broken in many places and the occurrence of any one case of cancer could be avoided in several different ways. Examples are given of the way different aspects of lifestyle interact, and particular attention is paid to the consumption of ethanol which has a major impact on the incidence of human cancer, although it does not appear to be a carcinogen in animal experiments.

Alcohol Drinking↗
PubMed1989

Cancer near potential sites of nuclear installations.

Mortality and census data for 400 districts of England and Wales were analysed with respect to existing sites of nuclear power stations and sites where the construction of such installations had been considered or had occurred at a later date (potential sites). Excess mortality due to leukaemia and Hodgkin's disease in young people who lived near potential sites was similar to that in young people who lived near existing sites. Areas near existing and potential sites might share unrecognised risk factors other than environmental radiation pollution.

Adolescent↗