Richard Doll

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Sir William Richard Shaboe Doll CH OBE FRS ([28 October] 1912–24 July 2005) was a British physiologist who became the foremost epidemiologist of the 20th century, turning the subject into a rigorous science. He was a pioneer in 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. Doll failed the mathematics scholarship from the effects of drinking too much of the College's own-brewed 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' 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 1955 Doll reported a case controlled study that has firmly established the relationship between asbestos and lung cancer.

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, 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 Centre at the John Radcliffe Hospital, Oxford, working as part of the Clinical Trial Service Unit, 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.

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.

Controversy

After his death, controversy arose over some of his work because his papers, held at the Wellcome Foundation Library, showed that for many years he had received consultancy payments from chemical companies whose products he was to defend in court. These include US$1,500 per day consultancy fee from Monsanto for a relationship which began in 1976 and continued until 2002. He also received fees from the Chemical Manufacturers Association, Dow Chemicals, and ICI. Some donations, including a £50,000 gift from asbestos company Turner and Newall, were given in public ceremony to Green College Oxford where his wife was Warden, but most fees and payments remained undisclosed to the public, Oxford University and colleagues until his death. His defenders point out that his connections to industry were widely known by those in the field, that he did his work before formal disclosure of commercial interests became commonplace and that on occasion, he came to conclusions that were unpalatable to the companies who consulted him. His own view, as reported by Richard Peto, was that it was necessary to co-operate with companies for access to data which could prove their products to be dangerous.

Bibliography

• Doll, Richard, and Hill, A. Bradford (30 September 1950). Smoking and carcinoma of the lung. Preliminary report. British Medical Journal 2 (4682): 739-748. PMID 14772469.
• Doll, Richard; and F. Avery Jones (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.
• Doll, Richard, and Hill, A. Bradford (26 June 1954). The mortality of doctors in relation to their smoking habits. A preliminary report. British Medical Journal (4877): 1451-55. PMID 13160495.
• Doll, Richard (December 1955). Mortality from lung cancer in asbestos workers. British Medical Journal: 1281.
• Doll, Richard (Fall 2002). Proof of causality: deduction from epidemiological observation. Perspectives in Biology and Medicine 45 (4): 499-515. PMID 12388883.
• Doll, Richard, et al. (26 June 2004). Mortality in relation to smoking: 50 years' observations on male British doctors. British Medical Journal 328 (7455): 1519. PMID 15213107.
• 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

• Richard Doll, An Epidemiologist Gone Awry
• Richard Doll Building by Nicholas Hare Architects LLP
• BBC News obituary Sir Richard Doll: A life's research
• BBC Experts Examined - Sir Richard Doll
• 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
• The Guardian (Sarah Boseley) Expert revered for painstaking work that proved link between smoking and cancer
• The Guardian (Sarah Boseley) Company paid for published review
• The Guardian (Sarah Boseley) Intervention in Vietnam inquiry