Richard Doll

Sir William Richard Shaboe Doll CH OBE FRS (28 October 1912–24 July 2005) was a British epidemiologist, physiologist, and a pioneer in the research linking smoking to health problems. With Ernst Wynder, Bradford Hill and Evarts Graham, he was the first in the modern world to prove that smoking caused lung cancer and increased the risk of heart disease. German researchers had established this association in the 1930s, although that work was not widely appreciated until recently (Robert Proctor, The Nazi War on Cancer, 1999). He also did pioneering work on the relationship between radiation and leukemia as well as that between asbestos and lung cancer, and alcohol and breast cancer.

Biography

Doll was born at Hampton into an affluent family, though his father's work as a doctor was cut short by multiple sclerosis. Educated first at Westminster School, Doll originally then intended (against the wishes of his parents that he become a doctor like his father) to study mathematics at Trinity College, Cambridge. Reportedly, Doll failed the math scholarship exam due to drinking too much Trinity College homebrew beer the night before. He subsequently chose to study medicine at St Thomas' Hospital Medical School from where he graduated in 1937. Doll was a socialist, and one of the significant figures in the Socialist Medical Association whose campaign helped lead to the creation of Britain's postwar National Health Service. He joined the Royal College of Physicians after the outbreak of World War II and served for much of the war as a part of the Royal Army Medical Corps on a hospital ship as a medical specialist.

After the war, Doll returned to St Thomas's to research asthma. In 1948 he joined a research team under Dr Francis Avery-Jones at the Central Middlesex Hospital, run under the auspices of the statistical research unit of the Medical Research Council. Over a 21 year career in the unit, Doll rose to become its director. His research there initially consisted of disproving the then-held belief that peptic ulceration was caused by heavy responsibility, but instead stress. In 1950, he then undertook with Austin Bradford Hill a study of lung cancer patients in 20 London hospitals, at first under the belief that it was due to the new material tarmac, or motor car fumes, but rapidly discovering that tobacco smoking was the only factor they had in common. Doll himself stopped smoking as a result of his findings, published in the British Medical Journal in 1950, which concluded;

"The risk of developing the disease increases in proportion to the amount smoked. It may be 50 times as great among those who smoke 25 or more cigarettes a day as among non-smokers."

Four years later, in 1954 the British doctors study, a study of some 40 thousand doctors over 20 years, confirmed the suggestion, based on which the government issued advice that smoking and lung cancer rates were related.

In 1966 Doll was elected to the Royal Society. The citation stated;

Doll is distinguished for his researches in epidemiology & particularly the epidemiology of cancer where in the last 10 years he has played a prominent part in (a) elucidating the causes of lung cancer in industry (asbestos, nickel & coal tar workers) & more generally, in relation to cigarette smoking, and (b) in the investigation of leukaemia particularly in relation to radiation, where using the mortality of patients treated with radiotherapy he has reached a quantitative estimate of the leukaemogenic effects of such radiation. In clinical medicine he has made carefully controlled trials of treatments for gastric ulcer. He has been awarded the United Nations prize for outstanding research into the causes & control of cancer & the Bisset Hawkins medal of the Royal College of Physicians for his contributions to preventative medicine

In 1969, Doll moved to Oxford University, to sit as the Regius Professor of Medicine, succeeding the clinical researcher Sir George Pickering.

Initially, epidemiology was held in low regard, but in his time at Oxford he helped reverse this. He was the primary agent behind the creation of Green College, a medical-only college, from where he retired in 1983.

Doll also helped found the National Blood Service, and was key in avoiding a system of paying donors for their blood, as had been adopted in the United States. His continued work into carcinogens at the Imperial Cancer Research Center, working as part of the Clinical Trial Service Unit at Oxford, notably including a study undertaken with Sir Richard Peto, in which it was estimated that tobacco, along with infections and diet, caused between then three quarters of all cancers, which was the basis of much of the World Health Organisation's conclusions on environmental pollution and cancer.

However after his death, researchers have found that Doll was taking secret payouts from various industrial groups.

An analysis of the academic literature on occupational cancer found: 'The most striking case is that of Sir Richard Doll, co-author (with Richard Peto) of one of the most influential papers in cancer epidemiology, one that concluded that only a small percentage of cancer was caused by environmental exposures.' The same paper produced HSE's 'best overall estimate available' of a 4 per cent occupational contribution to the total cancer incidence (Risks 225).

New analysis, due to be published in the American Journal of Industrial Medicine, shows Doll had a long term financial relationship with Monsanto which lasted from 1970 to 1990. The authors describe a letter from a Monsanto epidemiologist renewing Doll's contract for £1,000 per day from Monsanto.

The Doll and Peto paper was published in 1981. The Monsanto letter formed part of dossier of documents revealing Doll's relationships with companies and trade associations.

For example, in a paper on vinyl chloride cancer risks which was later to be heavily cited by industry groups, Doll did not disclose receiving £15,000 plus expenses from the Chemical Manufacturers' Association and the vinyl chloride manufacturers ICI and Dow.

Doll was also receiving payments at the same time from Monsanto, another large producer of vinyl chloride. A report issued by Hazards magazine in 2005 estimated that the real occupational cancer prevalence was at least twice and could be four times Doll's estimate, claiming up to 24,000 lives a year, compared to HSE's estimate of between 3,000 and 12,000 deaths.

Doll was Knighted in 1971, and made a Companion of Honour in 1996 for "services of national importance". He was made a Fellow of the Royal Society, awarded the Presidential Award of the New York Academy of Sciences as well as a UN Award for his research into cancer. In April 2005, he was awarded the Saudi Arabian King Faisal International Prize for medicine jointly with Peto for their work on diseases related to smoking. He was also awarded honorary degrees by thirteen different universities.

He died on 24 July, 2005, at the John Radcliffe Hospital in Oxford after a short illness. The solicitor Martyn Day, faced with Doll as a courtroom opponent on two occasions, described him as "the most impressive expert witness I've ever seen. The effect was; "If I'm saying it, it's almost certain to be true." "

Bibliography

• Doll, Richard (30 September 1950). "Smoking and carcinoma of the lung. Preliminary report". British Medical Journal. 2 (4682): 739–748. PMID 14772469. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
• Doll, Richard (1951). Occupational Factors in the Aetiology of Gastric and Duodenal Ulcers, With an Estimate of Their Incidence in the General Population. London: H.M. Stationery Office. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
• Doll, Richard (26 June 1954). "The mortality of doctors in relation to their smoking habits. A preliminary report". British Medical Journal (4877): 1451–55. PMID 13160495. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
• Doll, Richard (2002). "Proof of causality: deduction from epidemiological observation". Perspectives in Biology and Medicine. 45 (4): 499–515. PMID 12388883. {{cite journal}}: Unknown parameter |month= ignored (help)
• Doll, Richard (26 June 2004). "Mortality in relation to smoking: 50 years' observations on male British doctors". British Medical Journal. 328 (7455): 1519. PMID 15213107. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
• Proctor, Robert N. (1999). The Nazi War on Cancer. Princeton, N.J.: Princeton University Press. ISBN 0-691-00196-0.

Source

• Royal Society nomination

External links

• BBC News obituary
• The Times obituary
• Associated Press obituary
• The Independent obituary
• Godfather of Anti-smoking Movement Dies At 92
• Interview with Richard Doll
• Images from The National Portrait Gallery