Epidemiology Triumphs

&

Stories of Discovery

Are you sick and tired of hearing smoking and lung cancer used over and over again as the prime example of what epidemiologists do and contribute to public health? Well, your days of misery are over. Thanks to Diana Pettiti, Kaiser Permanente epidemiologist, a new list of 55 contributions which epidemiology has made to public health has been prepared. Most of the findings were of risk factors which increased the risk of disease, but about a third were for factors which protect against disease.

Speaking at the Congress of Epidemiology 2001 in Toronto, Pettiti mentioned she had prepared the list in anticipation of being on the panel at the Congress. She did not get to show her list at the time, so The Epi Monitor arranged to obtain the list and is making it available to the epidemiology community.

Criteria

The criteria for including risk or protective factors on the list were 1) there is widespread agreement that the association is causal, and 2a) the initial hypothesis was derived from an epidemiologic study (sometimes incidentally) and was subsequently confirmed as causal in a clinical trial or epidemiologic study, or 2b) an initial clinical observation was made or a cluster was noted and subsequent epidemiologic studies were able to explain the initial the initial observations to discover or establish the risk or protective factor.

 

Call For More Examples

The Epi Monitor invites readers to submit other examples both historical and modern. Simply click on "Contact Us" and send an email with your nominations for the list and with an accompanying justification for each example. As new contributions to epidemiology are reviewed and qualify to be added, the list will be modified and kept current on The Epi Monitor website.

 

Call For Commentaries and Anecdotes

 

In addition, we would like to add short commentaries by epidemiologists who can relate anecdotes or other interesting facts and observations about the discoveries listed here. Each discovery started as a hypothesis and had to navigate the demanding pathway from initial observation through subsequent findings and across the threshold of causality before being widely accepted. Any readers familiar with this pathway for any of the discoveries are invited to submit comments. Dr Petitti offered to get the ball rolling in the near future with a couple or three paragraphs about toxic shock syndrome and tampon use which she is very familiar with. We will post these "stories of discovery" as we receive them.

 

Epidemiology Triumphs

N= 55

Updated July 30, 2001 (More Triumphs To Be Added)

Category	Disease	Risk Factor	Direction (IR=Increased Risk P=Protective)
ALCOHOL
	esophageal cancer	alcohol (interaction with smoking)	IR
VIRUSES
	liver cancer	hepatitis B virus	IR
	Burkitt's lymphoma	Epstein Barr virus	IR
	Kaposi's sarcoma	Herpes simples virus type 8	IR
	cervical cancer	something transmitted sexually (human papilloma virus)	IR
	nasopharyngeal carcinoma	Epstein Barr virus	IR
	yellow fever	"something transmitted by mosquitoes"	IR
	nv Creutzfeldt-Jacob Disease	prions (interaction with genotype)	IR
BACTERIA
	cholera	"something in water" (vibrio cholera)	IR
	peptic ulcer	Helicobacter pylori	IR
	puerperal fever	"something on doctors' hands"(group B Streptococcus/step)	IR
NUTRITION
	pellagra	"something in food" (niacin)	P
	neural tube defects	folic acid, folate	P
	oral clefts	folic acid	P
OCCUPATION
	lung cancer	asbestos (interaction with smoking)	IR
	bladder cancer	aniline dye	IR
	mesothelioma	asbestos	IR
	lung cancer	asbestos (interaction with smoking)	IR
	angiosarcoma	vinly chloride	IR
	infertility (male)	DBCP	IR
	nasal cancer	nickel	IR
	lung cancer	"something in uranium mines" (interaction with smoking)	IR
ENVIRONMENT
	cancer	arsenic	IR
	dental caries	fluoride	P
DRUGS & DEVICES
	myocardial infarction	aspirin	P
	micoagthnia	iso-retinone during pregnancy	IR
	Dalkon Shield IUD	pelvic inflammatory disease	IR
	Dalkon Shield IUD	septic abortion	IR
HORMONES
	clear cell adenocarcinoma of the vagina	diethylstilbesterol	IR
	venous thromoembolism	combined estrogen/progestin oral contraceptives	IR
	venous thromoembolism	post-menopausal estrogen	IR
	ovarian cancer	oral contraceptives	P
	endometrial cancer	combined estrogen/progestin oral contraceptives	P
	endometrial cancer	post-menopausal estrogen	IR
	iron deficiency anemia	oral contraceptives	P
	benign breast disease	oral contraceptives	P
	myocardial infarction	oral contraceptives (interaction with smoking)	IR
	ischemic stroke	oral contraceptives (interaction with hypertension; modified by dose)	IR
GENETICS
	breast cancer	"something genetic" (BRCA 1, BRCA 2 mutations)	IR
	ovarian cancer	"something genetic" (BRCA 2 mutations)	IR
	colon cancer	"something genetic (APC 1 mutations)	IR
MISCELLANEOUS
	toxic shock syndrome	super absorbent tampons	IR
	SIDS	prone sleep position	IR
	Reye's syndrome	aspirin (interaction with infection)	IR
SMOKING
	lung cancer	smoking	IR
	coronary disease	smoking	IR
	hemorrhagic stroke	smoking	IR
	ischemic stroke	smoking	IR
	abdominal aortic aneurysm	smoking	IR
	peripheral vascular disease	smoking	IR
	Parkinson's Disease	smoking	P
	ulcerative colitis	smoking	P
	laryngeal cancer	smoking	IR
	intrauterine growth retardation	smoking during pregnancy	IR
	toxemia/pre-eclampsia	smoking during pregnancy	P