THE MORTALITY OF DOCTORS IN RELATION TO THEIR SMOKING HABITS - A PRELIMINARY REPORT
THE MORTALITY OF DOCTORS IN RELATION TO THEIR SMOKING HABITS - A PRELIMINARY REPORT
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DOI：
10.1136/bmj.1.4877.1451
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发表时间：
1954-01-01
影响因子：
105.7
通讯作者：
HILL, AB
中科院分区：
文献类型：
--
作者：
DOLL, R;HILL, AB
在过去的五年里，对肺癌患者和非肺癌患者的吸烟习惯进行了大量的研究（Doll和Hill，1950年，1952年; Levin，Gold-stein和Gerhardt，1950年;米尔斯和Porter，1950年; Schrek，Baker，Ballard和Dolgoff，1950年; Wynder和Graham，1950年; McConnell，Gordon和Jones，1952年; Koulumies，1953; Sadowsky，Gilliam，and Cornfield，1953; Wynder and Cornfield，1953; Breslow，Hoaglin，Rasmussen，and Abrams，1954;沃森and Conte，1954）.所有这些研究都一致表明，肺癌患者中的重度吸烟者比其他疾病患者中的重度吸烟者多，不吸烟者少。除了一个例外（麦康奈尔、戈登和琼斯发现的不吸烟者比例之间的差异），这些差异大得足以说明问题。因此，虽然不同的作者都表明肺癌与吸烟量之间存在“关联”，但他们的解释不同。有些人认为，唯一合理的解释是吸烟是导致这种疾病的一个因素;另一些人则不准备推断因果关系，对这种联系不予解释。在我们看来，进一步的类似回顾性研究不可能在物质上增进我们的知识，也不可能对这种联系的性质有任何新的了解。如果这些研究所产生的证据中还有任何未被发现的缺陷，那么只有通过一些全新的方法才能暴露出来。我们认为这种做法应该是”前瞻性的“。“* 它应确定今后在已知吸烟习惯的人群中出现这种疾病的频率。
In the last five years a number of studies have been made of the smoking habitsof patients with and without lung cancer (Doll and Hill, 1950, 1952; Levin, Gold--stein, and Gerhardt, 1950; Mills and Porter, 1950; Schrek, Baker, Ballard, and Dolgoff, 1950; Wynder and Graham, 1950; McConnell, Gordon, and Jones, 1952; Koulumies, 1953; Sadowsky, Gilliam, and Cornfield, 1953; Wynder and Cornfield, 1953; Breslow, Hoaglin, Rasmussen, and Abrams, 1954; Watson and Conte, 1954). All these studies agree in showing that thereare more heavy smokers and fewer non-smokers among patients with lung cancer than among patients with other diseases. With one exception (the difference between the proportions of non--smokers found by McConnell, Gordon, and Jones) these differences are large enough to be important. While, therefore, the various authors have all shown that there is an" association" between lung cancer and the amount of tobacco smoked, they have differed in-their interpretation. Some have considered that the only reasonable explanation is that smoking is a factor in-the production of the disease; others have not been prepared to deduce causation and have left the associa-tion unexplained.Further retrospective studies of that same kind would seem to us unlikely to advance our knowledge materially-or to throw any new light upon the nature of the association. If, too, there were any undetected flaw in the evidence that such studies have produced, it would be exposed only by some entirely new approach. That approach we considered should be" prospective."* It should determine the frequency with which the disease appeared, in the future, among groups of persons whose smoking habits were already known.