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Cancer in the tropics: geographical pathology and the formation of cancer epidemiology

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Abstract

Researchers have long been concerned with cancer in what has been called the tropics, developing world, and low- and middle-income countries. Global health advocates' recent calls to attend to an emergent cancer epidemic in these regions were only the latest effort in this long history. Researchers, known as geographical pathologists, sought to determine the etiologies of cancer and other non-infectious diseases between the 1920s and the 1960s by comparing their occurrence across different environments. The geographical pathologists used the concept of the environment to analyze the influences that natural and artificial surroundings had on health. While the international network of geographical pathology fostered medical thinking about environmental health in the early and mid-twentieth century, the very meaning of environment, alongside the scientific methods for studying the environment, changed in this period. In the 1960s, epidemiology, previously used for the study of infectious diseases, displaced geographical pathology as the cohesive framework of cancer research. This signaled a shift in research focus, from one dedicated to diagnostics and the environment to one centered on population and statistical studies. This article shows that it was not the lack of knowledge about cancer in the developing world but rather specific configurations of knowledge that shaped which cancer interventions in the developing world researchers and public health officials conceived.

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Notes

  1. These countries included Germany, the United States, Cuba, Colombia, Argentina, England, Austria, Belgium, Canada, Chile, Denmark, Spain, Estonia, France, Greece, the Netherlands, the Dutch Indies, Hungary, Italy, Japan, Latvia, Lithuania, Mexico, Norway, Poland, Portugal, Romania, Russia, Sweden, Switzerland, Czechoslovakia, Turkey, Yugoslavia, South Africa, Brazil, and Finland.

  2. Bacteriology itself was not a uniform field, and some bacteriologists responded to this criticism by studying the environmental effects on bacterial virulence (Mendelsohn 1996).

  3. George Weisz (2014) provides an account of the history of the related but different category of chronic diseases that emerged in the United States in the 1930s.

  4. For a overview review of the history of aflatoxin and other mycotoxins, see Pitt and Miller (2017).

  5. C. A. Linsell to G. T. O’Conor, 21 June 1967, Research Centre—Nairobi, R 4/2 Nair, First Generation of Files, 1967 – 1984, Archives of the International Agency for Research on Cancer, Lyon.

  6. Kreberg, L., et al. “Working Paper on a Proposed International Cancer Research Programme for WHO,” 1 March 1959, p. 15, WHO Library, Geneva: MHO/AD/19.59.

  7. “General Comments on the Future Developments of Epidemiological and Environmental Biology with Special Reference to a Multi-Disciplinary Approach,” IARC Scientific Council, 4-5 April 1966, SC/1/5, p. 1, WHO Archives, Geneva: N70/370/2.

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Acknowledgements

I would like to thank Allan Brandt, Marie Burks, Carlo Caduff, Spring Greeney, David S. Jones, Joseph La Hausse de Lalouvière, Jia Hui Lee, Harriet Ritvo, and Cecilia van Hollen for their feedback on earlier versions of this text. I am grateful for the comments on this material from the participants of the Wellcome-funded Workshop on Cancer and the Global South in May 2017 in London, of the HASTS Program Seminar at MIT, and of the Harvard History of Medicine Working Group. I am also thankful for the comments from the three anononymous reviewers and the editors of BioSocieties.

Archives consulted

Archives of the International Agency for Research on Cancer, Lyon.

Archives of the World Health Organization, Geneva

Funding

This material is based upon work supported by the National Science Foundation under Grant No. 1555448. This research was assisted by a Mellon/ACLS Dissertation Completion Fellowship from the American Council of Learned Societies and by a Price Fellowship from the Science History Institute.

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  1. Science History Institute, Philadelphia, PA, USA

    Lucas M. Mueller

  2. Program in History, Anthropology, and Science, Technology, and Society, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, 02139, USA

    Lucas M. Mueller

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Mueller, L.M. Cancer in the tropics: geographical pathology and the formation of cancer epidemiology. BioSocieties 14, 512–528 (2019). https://doi.org/10.1057/s41292-019-00152-w

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