Historical Evolution of Disease Mapping in General and Specifically of Cancer Mapping

Abstract

Maps demonstrate with a unique efficiency the distribution of phenomena in space. Maps of disease, like other types of map, convey factual information. But, by illustrating disease distributions which either change over short time-periods or vary non-randomly in space, disease maps also inevitably stimulate the formation of causal hypotheses. The earliest examples of disease mapping (medical cartography) were stimulated by the search for clues about the origins of the dreaded infections. Stevenson (1965) draws attention to several spot maps prepared in the context of yellow fever on the eastern seaboard of the United States at the end of the eighteenth century at the time of the debate between contagionists and anticontagionists. Two spot maps (Fig.1) were used by Valentine Seaman in 1798 to illustrate a paper on yellow fever in New York in 1796 and 1797. Twenty-two years later Felix Pascalis-Ouvière (1820) drew a careful spot map to show, yet again, the distribution of cases of yellow fever in New York, in an effort to establish causative factors. A map produced by Cartwright in 1826 of a locality, Natchez, in Mississippi, linked environmental factors closely to an epidemic of the disease. Seaman, Pascalis-Ouvière and Cartwright were anti-contagionists and at that time the map was, in large measure, the weapon of this faction. The extension of the epidemic, as shown on the map, was facilitated, in Cartwright’s view, by ‘a damp climate, an eighty degree (i. e. 27 °C) temperature ... combined with the special effluvia of rotting pork and oysters to envelop the community in a sort of pathogenic mist. The inevitable consequence was widespread yellow fever’. Born largely of experience with yellow fever in the United States and with cholera in Europe disease mapping became relatively commonplace during the subsequent decades.

‘... to obtain a view of the Geographical extent of the ravages of this disease, and to discover the local conditions that might influence its progress and its degree of fatality ... Geographical delineation is of the utmost value, and even indispensable; for while the symbols of the masses of statistical data in figures, however clearly they might be arranged in Systematic Tables, present but a uniform appearance, the same data presented on a Map, will convey at once the relative bearing and proportion of the single data [sic], together with their position, extent and distance, and thus, a Map will make visible to the eye the development and nature of any phenomenon in regard to its Geographical distribution.’ (Petermann, 1852)