Saturday, December 16, 2006

In the olden days, when I lived in Oxford and worked at Oxford University Press I was honoured to be made a Supernumerary Fellow of a very new Oxford institution, Green College. I was reminded of those days by the receipt of their alumni magazine, Green College News, this morning.

The creation of Green College was made possible by money from Cecil and Ida Green, the founders of Texas Instruments, and inspiration and vision from Richard Doll. He was convinced that, as medical sciences and adjacent disciplines exploded in importance, traditional Oxford colleges would simply not have the resource to offer scientists and scholars enough support. The only solution was a brand new college. He dedicated his later years to the college and ensured its success not just when he was Warden but in supporting the Wardens who succeeded him.

I spent time with Doll during the publication of a small book originally published by the National Institutes of Health as an extended journal article. We republished in paperback as The Causes of Cancer and sold quite a few copies. Neither Doll nor his distinguished co-author Richard (now Sir Richard) Peto would accept personal royalties. It was small but startingly important and is still the starting point for discussion about the effects of smoking, food and other environmental factors on cancer incidence.

Sir Richard Doll

I have always regarded Richard Doll as an example of the very best scientist, very best scholar, very best university politcian, very best person and not a bad wicketkeeper in his prime. I was therefore horrified by the recent attacks on him suggesting that his payment for consultancy by chemical companies threw suspicion on his research findings and statements. This piece by Cristina Odone puts another slant and finishes by saying:

Each age has its mores: we cannot expect the giants of the past to live by ours.

This is true but might imply he did something wrong. Rubbish. Richard Doll has saved more lives through his research than almost any other medical scientist in history. He lived frugally and his earnings went to support Green College and other causes. He nurtured students and encouraged colleagues.The character assassins should  be ashamed of themselves and we should continue to be grateful for human DNA which occasionally produces simply great human beings.

Incidentally here is a key slide of Doll's epidemiological experiment which proved the link between smoking and cancer and a quote from the British Medical Journal:

The study was remarkable in many ways. First was its magnitude. Despite the fact that it started in 1951, when England was still recovering from the economic devastation of World War II, the field of epidemiology was just emerging, and 13 more years would pass until the U.S. Surgeon General’s Report on Smoking and Health, Dr. Doll was able to recruit 34,439 of the 40,000 male physicians in the United Kingdom to participate in the study. Second was its duration. The study spanned 50 years, capturing the time in the subjects’ lives when tobacco use was just starting to show an impact on mortality, and continuing through most of their deaths, when the risk of use again met the risk of no use. This is illustrated in Figure1, which approaches perfection and evokes accelerated heart beats and gasps for air among statisticians, much as Michelangelo’s David does among artists. Third was its execution, which resulted in attrition of only 8.8% over 50 years, an average of 63 people or .147% per year. Finally are the results, which tell us that smoking cigarettes reduces life span by approximately 10 years, and increases the likelihood of death by 100% at age 50, 111% at age 60, 121% at age 70, 45% at age 80, and 26% at age 90 and will be the likely cause of death for two thirds of the people who smoke. It also tells us that quitting smoking adds 10 years to a person’s life if they quit by age 30, 9 years if by age 40, 6 years if by age 50, and 3 years if by age 60.