Medicine: Beyond Any Doubt

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For cigarette smokers, famed Surgeon Evarts A. Graham of St. Louis had news last week.

"Dr. Ernest L. Wynder and I have reproduced cancer experimentally in mice by using merely the tars from tobacco smoke. This shows conclusively that there is something in cigarette smoke which can produce cancer. This is no longer merely a possibility. Our experiments have proved it beyond any doubt."

What Dr. Graham stated as proven fact had long been suspected. Beginning in the 1930s, medical statisticians noticed an unusual rise in the number of cases of lung cancer. Part of the apparent increase was due simply to the fact that doctors were becoming more skilled in diagnosis, part to the fact that many more people were living long enough to contract cancer.

But there was something else. New Orleans' Surgeon Alton Ochsner noted that most of the patients on whom he performed daring and radical operations (removal of all or part of a lung) were men over 40 who had long been heavy cigarette smokers. He thought he saw a case of cause and effect.

First Correlation. Not until 1949 did an earnest young researcher, Ernest Wynder, then a medical student at Washington University under Surgeon Graham, supply statistical evidence: among 200 victims of lung cancer, 95.5% were men with long histories of cigarette smoking. Other researchers began to check their files on lung cancer patients and found the same thing. In Britain a massive study pointed even more sharply to the same conclusion (TIME, Dec. 22). In Denmark cancer experts who had once pooh-poohed the idea gathered more data and reversed themselves.

But no cancer-causing agent was known in tobacco smoke, so medical researchers were careful not to fall into the error of arguing post hoc, ergo propter hoc. For a long time, their scientific caution would let them say no more than that there must be a "correlation" between heavy, continued cigarette smoking and lung cancer.

Working with Research Assistant Adele B. Croninger, Drs. Graham and Wynder obtained tar from a machine which "smokes" thousands of cigarettes, then painted the tar on the backs of mice. It produced scores of cancers. While these skin cancers are not identical with lung cancer in man, they are so similar that the researchers are confident that human lung tissue reacts the same way.

Said Dr. Ochsner: "This study of Drs. Graham and Wynder [published in Cancer Research, out this week] has proven beyond any doubt that in tobacco tar there is an agent which produces cancer. If we could find it and extract it, smoking might not be harmful. But, on the basis of the number of people who are smoking now, I predict that by 1970 one out of every two or three men with cancer will have cancer of the lung—or one out of every ten or twelve men living."

The figures are not yet so horrendous as Dr. Ochsner foresees, but lung cancer is multiplying faster than any other form of cancer, and, as a cause of death, faster than any other disease. Since 1933 the U.S. death rate from lung cancer (allowing for the growth of population) has quadrupled for men and doubled for women. The 1953 toll is expected to be 18,400 men, 3,600 women; 94% of the men and 92% of the women will be over 45. In the same 20 years, U.S. cigarette consumption has shot up from 111 billion to about 433 billion.

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