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Encyclopedia > British Doctors Study

The British doctors study is the generally accepted name of a prospective clinical trial which has been running from 1951 to 2001, and in 1956 provided convincing statistical proof that tobacco smoking increased the risk of lung cancer. In medicine, a clinical trial (synonyms: clinical studies, research protocols, medical research) is a research study. ... 1951 was a common year starting on Monday; see its calendar. ... 2001 is a common year starting on Monday of the Gregorian calendar. ... 1956 was a leap year starting on Sunday. ... Holding a lit cigarette Tobacco smoking is the act of smoking tobacco products, especially cigarettes and cigars. ... Lung cancer is a malignant tumour of the lungs. ...

Contents

Context

Although there had been suspicions of a link between smoking and various diseases, the evidence for this link had been largely circumstantial. In fact, smoking had been advertised as "healthy" for many years, and there had been no clear explanation why rates of lung cancer had soared.


To further investigate the link, the Medical Research Council (MRC) instructed its Statistical Research Unit (later the Oxford-based Clinical Trial Service Unit) to conduct a prospective study into the link. This approach to medical questions was fairly new: in the 1954 "Preliminary report"1, the researchers felt it necessary to offer a definition of the prospective principle. Current MRC logo The Medical Research Council (MRC) is a UK organisation dedicated to promot[ing] the balanced development of medical and related biological research in the UK. Organisation The MRC is one of seven Research Councils and is answerable to, although politically independent from, the Office of Science and... Oxford is a city and local government district in Oxfordshire, England, with a population of 134,248 (2001 census). ... 1954 was a common year starting on Friday of the Gregorian calendar. ...


The study, when it was published in 19562, would herald a new type of scientific research, showed to relevance of epidemiology and medical statistics in questions of public health, and vitally linked tobacco smoking to a number of serious diseases. 1956 was a leap year starting on Sunday. ... Epidemiology is the study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to control of health problems (Last 2001). ... Public health is an aspect of health services concerned with threats to the overall health of a community based on population health analysis. ...


The study

In October 1951, the researchers wrote to all registered male physicians in the United Kingdom, and obtained responses in two-thirds, 34439 of them. No further cohorts were recruited.


The respondents were stratified into decade of birth, and their cause-specific mortality, as well as general physical health and current smoking habits, followed up in further questionnaires in 1957, 1966, 1971, 1978, 1991, and finally in 2001. 1957 was a common year starting on Tuesday (link will take you to calendar). ... 1966 was a common year starting on Saturday (the link is to a full 1966 calendar). ... 1971 is a common year starting on Friday (click for link to calendar). ... 1978 was a common year starting on Sunday (the link is to a full 1978 calendar). ... 1991 is a common year starting on Tuesday of the Gregorian calendar. ... 2001 is a common year starting on Monday of the Gregorian calendar. ...


Statistical analysis

Response rates were quite high, making appropriate statistical analyses possible. The result was, that both lung cancer and "coronary thrombosis" (the then-prevalent term for myocardial infarction) occurred markedly more often in smokers. A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, totally occluding the artery and preventing blood flow downstream. ...


In the follow-up reports, published every ten years (see the 2004 article3 for a summary) more information became available. A major conclusion of the study is, for example, that smoking decreases life span up to 10 years, and that more than 50% of all smokers die of a disease known to be smoking-related.


Impact and personalities

The true impact of the study is difficult to gauge, as smoking was not considered a public health problem in the 1950s, and the appreciation of the problem would only grow in the ensuing decades. Nevertheless, the British doctors study was to provide conclusive evidence of linkage between smoking and lung cancer, myocardial infarction, respiratory disease and other smoking-related illnesses. Millennia: 1st millennium - 2nd millennium - 3rd millennium Events and trends Technology United States tests the first fusion bomb. ...


The original study was run by Richard Doll and Austin Bradford Hill. Richard Peto joined the team in 1971 and would, with Doll, prepare all subsequent reports for publication. Doll and Peto are both celebrated epidemiologists, and their fame is largely based on their pioneering work in the study mentioned. They would continue their work on other cardiovascular studies, for example the more recent Heart Protection Study. Richard Doll (b. ... Austin Bradford Hill (July 8, 1897 - April 18, 1991) English epidemiologist and statistician pioneered the randomised clinical trial and, together with Richard Doll, was the first to demonstrate the connection between cigarette smoking and lung cancer. ... 1971 is a common year starting on Friday (click for link to calendar). ... The Heart Protection Study is a large randomized controlled trial by the Medical Research Council (MRC) in the United Kingdom. ...


See also

Holding a lit cigarette Tobacco smoking is the act of smoking tobacco products, especially cigarettes and cigars. ... The Heart Protection Study is a large randomized controlled trial by the Medical Research Council (MRC) in the United Kingdom. ... The Framingham Heart Study is a cardiovascular study based in Framingham, Massachusetts. ... The Scandinavian Simvastatin Survival Study (also known under the abbreviation 4S) is a multicenter clinical trial that was performed in 1990s in Scandinavia. ...

References

  1. Doll R, Hill AB. The mortality of doctors in relation to their smoking habits. Br Med J 1954;228:1451-5. PMID 13160495. Reproduced in: BMJ 2004;328:1529-3. PMID 15217868.
  2. Doll R, Hill AB. Lung cancer and other causes of death in relation to smoking. A second report on the mortality of British doctors. BMJ 1956;233:1071-6. PMID 13364389.
  3. Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years' observation on male British doctors. BMJ 2004;328:1519-33. PMID 15213107.

 
 

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