Richard Doll
Encyclopedia
Sir William Richard Shaboe Doll CH
Order of the Companions of Honour
The Order of the Companions of Honour is an order of the Commonwealth realms. It was founded by King George V in June 1917, as a reward for outstanding achievements in the arts, literature, music, science, politics, industry or religion....

 OBE
Order of the British Empire
The Most Excellent Order of the British Empire is an order of chivalry established on 4 June 1917 by George V of the United Kingdom. The Order comprises five classes in civil and military divisions...

 FRS (28 October 1912 – 24 July 2005) was a British
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...

 physiologist who became the foremost epidemiologist of the 20th century, turning the subject into a rigorous science. He was a pioneer in research linking smoking
Tobacco smoking
Tobacco smoking is the practice where tobacco is burned and the resulting smoke is inhaled. The practice may have begun as early as 5000–3000 BCE. Tobacco was introduced to Eurasia in the late 16th century where it followed common trade routes...

 to health problems. With Ernst Wynder
Ernst Wynder
Ernst Ludwig Wynder was an American epidemiology and public health researcher who studied the risk factors of smoking tobacco. His 1950 coauthored publication of "Tobacco Smoking as a Possible Etiologic Factor in Bronchiogenic Carcinoma: A Study of 684 Proved Cases" appeared in the Journal of the...

, Bradford Hill
Austin Bradford Hill
Sir Austin Bradford Hill FRS , English epidemiologist and statistician, pioneered the randomized clinical trial and, together with Richard Doll, was the first to demonstrate the connection between cigarette smoking and lung cancer...

 and Evarts Graham, he was credited with being the first to prove that smoking caused lung cancer
Lung cancer
Lung cancer is a disease characterized by uncontrolled cell growth in tissues of the lung. If left untreated, this growth can spread beyond the lung in a process called metastasis into nearby tissue and, eventually, into other parts of the body. Most cancers that start in lung, known as primary...

 and increased the risk of heart disease
Heart disease
Heart disease, cardiac disease or cardiopathy is an umbrella term for a variety of diseases affecting the heart. , it is the leading cause of death in the United States, England, Canada and Wales, accounting for 25.4% of the total deaths in the United States.-Types:-Coronary heart disease:Coronary...

. German researchers had previously discovered this link in the 1930s, but that work was not widely known until recently. He also did pioneering work on the relationship between radiation and leukemia
Leukemia
Leukemia or leukaemia is a type of cancer of the blood or bone marrow characterized by an abnormal increase of immature white blood cells called "blasts". Leukemia is a broad term covering a spectrum of diseases...

 as well as that between asbestos
Asbestos
Asbestos is a set of six naturally occurring silicate minerals used commercially for their desirable physical properties. They all have in common their eponymous, asbestiform habit: long, thin fibrous crystals...

 and lung cancer
Lung cancer
Lung cancer is a disease characterized by uncontrolled cell growth in tissues of the lung. If left untreated, this growth can spread beyond the lung in a process called metastasis into nearby tissue and, eventually, into other parts of the body. Most cancers that start in lung, known as primary...

, and alcohol
Alcohol
In chemistry, an alcohol is an organic compound in which the hydroxy functional group is bound to a carbon atom. In particular, this carbon center should be saturated, having single bonds to three other atoms....

 and breast cancer
Breast cancer
Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...

.

Biography

Doll was born at Hampton
Hampton, London
Hampton is a suburban area, centred on an old village on the north bank of the River Thames, in the London Borough of Richmond upon Thames in England. Formerly it was in the county of Middlesex, which was formerly also its postal county. The population is about 9,500...

 into an affluent family, though his father's work as a doctor was cut short by multiple sclerosis
Multiple sclerosis
Multiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms...

. Educated first at Westminster School
Westminster School
The Royal College of St. Peter in Westminster, almost always known as Westminster School, is one of Britain's leading independent schools, with the highest Oxford and Cambridge acceptance rate of any secondary school or college in Britain...

, Doll originally then intended (against the wishes of his parents that he become a doctor like his father) to study mathematics at Trinity College, Cambridge
Trinity College, Cambridge
Trinity College is a constituent college of the University of Cambridge. Trinity has more members than any other college in Cambridge or Oxford, with around 700 undergraduates, 430 graduates, and over 170 Fellows...

. Doll failed the mathematics scholarship from the effects of drinking too much of the College's own-brewed beer the night before. He subsequently chose to study medicine at St Thomas's Hospital Medical School, King's College London
King's College London
King's College London is a public research university located in London, United Kingdom and a constituent college of the federal University of London. King's has a claim to being the third oldest university in England, having been founded by King George IV and the Duke of Wellington in 1829, and...

 from where he graduated in 1937. Doll was a socialist, and one of the significant figures in the Socialist Medical Association
Socialist Health Association
The Socialist Medical Association was founded in 1930, in order to campaign for a National Health Service in the United Kingdom. It took in many of those who had been active in the State Medical Service Association...

 whose campaign helped lead to the creation of Britain's postwar National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...

. He joined the Royal College of Physicians
Royal College of Physicians
The Royal College of Physicians of London was founded in 1518 as the College of Physicians by royal charter of King Henry VIII in 1518 - the first medical institution in England to receive a royal charter...

 after the outbreak of World War II
World War II
World War II, or the Second World War , was a global conflict lasting from 1939 to 1945, involving most of the world's nations—including all of the great powers—eventually forming two opposing military alliances: the Allies and the Axis...

 and served for much of the war as a part of the Royal Army Medical Corps
Royal Army Medical Corps
The Royal Army Medical Corps is a specialist corps in the British Army which provides medical services to all British Army personnel and their families in war and in peace...

 on a hospital ship as a medical specialist.

After the war, Doll returned to St Thomas' to research asthma
Asthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...

. In 1948 he joined a research team under Dr Francis Avery-Jones at the Central Middlesex Hospital
Central Middlesex Hospital
Central Middlesex hospital is in the centre of the Park Royal business estate, on the border of two London boroughs, Brent and Ealing.-Hospital role:CMH is a teaching hospital of Imperial College School of Medicine and part of the...

, run under the auspices of the statistical research unit of the Medical Research Council
Medical Research Council (UK)
The Medical Research Council is a publicly-funded agency responsible for co-ordinating and funding medical research in the United Kingdom. It is one of seven Research Councils in the UK and is answerable to, although politically independent from, the Department for Business, Innovation and Skills...

. Over a 21 year career in the unit, Doll rose to become its director. His research there initially consisted of disproving the then-held belief that peptic ulcer
Peptic ulcer
A peptic ulcer, also known as PUD or peptic ulcer disease, is the most common ulcer of an area of the gastrointestinal tract that is usually acidic and thus extremely painful. It is defined as mucosal erosions equal to or greater than 0.5 cm...

ation was caused by heavy responsibility, but instead stress. In 1950, he then undertook with Austin Bradford Hill
Austin Bradford Hill
Sir Austin Bradford Hill FRS , English epidemiologist and statistician, pioneered the randomized clinical trial and, together with Richard Doll, was the first to demonstrate the connection between cigarette smoking and lung cancer...

 a study of lung cancer patients in 20 London hospitals, at first under the belief that it was due to the new material tarmac
Tarmac
Tarmac is a type of road surface. Tarmac refers to a material patented by Edgar Purnell Hooley in 1901...

, or motor car fumes, but rapidly discovering that tobacco smoking
Tobacco smoking
Tobacco smoking is the practice where tobacco is burned and the resulting smoke is inhaled. The practice may have begun as early as 5000–3000 BCE. Tobacco was introduced to Eurasia in the late 16th century where it followed common trade routes...

 was the only factor they had in common. Doll himself stopped smoking as a result of his findings, published in the British Medical Journal
British Medical Journal
BMJ is a partially open-access peer-reviewed medical journal. Originally called the British Medical Journal, the title was officially shortened to BMJ in 1988. The journal is published by the BMJ Group, a wholly owned subsidiary of the British Medical Association...

 in 1950, which concluded;
"The risk of developing the disease increases in proportion to the amount smoked. It may be 50 times as great among those who smoke 25 or more cigarettes a day as among non-smokers."

Four years later, in 1954 the British doctors study
British Doctors Study
The British Doctors Study is the generally accepted name of a prospective cohort study which ran from 1951 to 2001, and in 1956 provided convincing statistical proof that tobacco smoking increased the risk of lung cancer.-Context:...

, a study of some 40 thousand doctors over 20 years, confirmed the suggestion, based on which the government issued advice that smoking and lung cancer rates were related.

In 1955 Doll reported a case controlled study that has firmly established the relationship between asbestos and lung cancer.

In 1966 Doll was elected to the Royal Society
Royal Society
The Royal Society of London for Improving Natural Knowledge, known simply as the Royal Society, is a learned society for science, and is possibly the oldest such society in existence. Founded in November 1660, it was granted a Royal Charter by King Charles II as the "Royal Society of London"...

. The citation stated:

Doll is distinguished for his researches in epidemiology, and particularly the epidemiology of cancer where in the last 10 years he has played a prominent part in (a) elucidating the causes of lung cancer in industry (asbestos, nickel & coal tar workers) & more generally, in relation to cigarette smoking, and (b) in the investigation of leukaemia particularly in relation to radiation, where using the mortality of patients treated with radiotherapy he has reached a quantitative estimate of the leukaemogenic effects of such radiation. In clinical medicine he has made carefully controlled trials of treatments for gastric ulcer. He has been awarded the United Nations prize for outstanding research into the causes & control of cancer & the Bisset Hawkins medal of the Royal College of Physicians for his contributions to preventative medicine


In 1969, Doll moved to Oxford University
University of Oxford
The University of Oxford is a university located in Oxford, United Kingdom. It is the second-oldest surviving university in the world and the oldest in the English-speaking world. Although its exact date of foundation is unclear, there is evidence of teaching as far back as 1096...

, to sit as the Regius Professor of Medicine
Regius Professor of Medicine
The title Regius Professor of Medicine, or similar, is a Regius professorship at the ancient universities of the United Kingdom — specifically Oxford, Cambridge, Glasgow, Aberdeen, Edinburgh and Dublin.-See also:* Regius Professor...

, succeeding the clinical researcher Sir George Pickering.

Initially, epidemiology was held in low regard, but in his time at Oxford he helped reverse this. He was the primary agent behind the creation of Green College
Green College, Oxford
Green College was a graduate college of the University of Oxford in England. It was centred around an architecturally appealing 18th century building: the Radcliffe Observatory, which is modelled after the ancient "Tower of the Winds" in Athens....

, which was founded in 1979. Doll was appointed the first Warden of Green College, from where he retired in 1983. Green College merged with Templeton College
Templeton College, Oxford
Templeton College was one of the constituent colleges of the University of Oxford, England. It was an all-graduate college, concentrating on the recruitment of students in business and management studies....

 in 2008 to become Green Templeton College
Green Templeton College, Oxford
Green Templeton College is a constituent college of the University of Oxford in the United Kingdom. It is the university's newest college having come into existence on 1 October 2008 from the merger of Green College and Templeton College...

, which is located on the site that was previously Green College.

Doll also helped found the National Blood Service
National Blood Service
The National Blood Service is the organisation for England and North Wales which collects blood and other tissues, tests, processes, and supplies all the hospitals in England and North Wales...

, and was key in avoiding a system of paying donors for their blood, as had been adopted in the United States. His continued work into carcinogen
Carcinogen
A carcinogen is any substance, radionuclide, or radiation that is an agent directly involved in causing cancer. This may be due to the ability to damage the genome or to the disruption of cellular metabolic processes...

s at the Imperial Cancer Research Centre
Cancer Research UK
Cancer Research UK is a cancer research and awareness charity in the United Kingdom, formed on 4 February 2002 by the merger of The Cancer Research Campaign and the Imperial Cancer Research Fund. Its aim is to reduce the number of deaths from cancer. As the world's largest independent cancer...

 at the John Radcliffe Hospital
John Radcliffe Hospital
The John Radcliffe Hospital is a large tertiary teaching hospital in Oxford, England.It is the main teaching hospital for Oxford University and Oxford Brookes University. As such, it is a well-developed centre of medical research. It also incorporates the Medical School of the University of Oxford....

, Oxford, working as part of the Clinical Trial Service Unit
Clinical Trial Service Unit
The Clinical Trial Services Unit is a medical research institute within Oxford University in the United Kingdom.It primarily conducts large scale clinical trials and epidemiological studies of chronic diseases, especially cancer and vascular conditions.It is located in the Richard Doll Building ...

, notably including a study undertaken with Sir Richard Peto
Richard Peto
Sir Richard Peto FRS is Professor of Medical Statistics and Epidemiology at the University of Oxford.He attended Taunton's School in Southampton and subsequently studied Natural Sciences at Cambridge University....

, in which it was estimated that tobacco, along with infections and diet, caused between them three quarters of all cancers, which was the basis of much of the World Health Organisation's conclusions on environmental pollution and cancer.

Doll was made a Fellow of the Royal Society
Royal Society
The Royal Society of London for Improving Natural Knowledge, known simply as the Royal Society, is a learned society for science, and is possibly the oldest such society in existence. Founded in November 1660, it was granted a Royal Charter by King Charles II as the "Royal Society of London"...

 in 1966, Knight
Knight
A knight was a member of a class of lower nobility in the High Middle Ages.By the Late Middle Ages, the rank had become associated with the ideals of chivalry, a code of conduct for the perfect courtly Christian warrior....

ed in 1971, and awarded the Edward Jenner Medal of the Royal Society of Medicine
Royal Society of Medicine
The Royal Society of Medicine is a British charitable organisation whose main purpose is as a provider of medical education, running over 350 meetings and conferences each year.- History and overview :...

 in 1981. In 1996 he was made a Companion of Honour
Order of the Companions of Honour
The Order of the Companions of Honour is an order of the Commonwealth realms. It was founded by King George V in June 1917, as a reward for outstanding achievements in the arts, literature, music, science, politics, industry or religion....

 for "services of national importance". International honours included the Presidential Award of the New York Academy of Sciences
New York Academy of Sciences
The New York Academy of Sciences is the third oldest scientific society in the United States. An independent, non-profit organization with more than members in 140 countries, the Academy’s mission is to advance understanding of science and technology...

 as well as a UN Award for his research into cancer. In April 2005, he was awarded the Saudi Arabia
Saudi Arabia
The Kingdom of Saudi Arabia , commonly known in British English as Saudi Arabia and in Arabic as as-Sa‘ūdiyyah , is the largest state in Western Asia by land area, constituting the bulk of the Arabian Peninsula, and the second-largest in the Arab World...

n King Faisal
King Faisal
-People:* Faisal of Saudi Arabia * Faisal I of Iraq , king of Greater Syria and king of Iraq* Faisal II of Iraq Iraq's last king-Other:*King Faisal Airbase, Tabuk, Saudi Arabia...

 International Prize for medicine jointly with Peto for their work on diseases related to smoking. In 2004, he was awarded the inaugural Shaw Prize
Shaw Prize
The Shaw Prize is an annual award first presented by the Shaw Prize Foundation in 2004. Established in 2002 in Hong Kong, it honours living "individuals, regardless of race, nationality and religious belief, who have achieved significant breakthrough in academic and scientific research or...

 for Life Sciences and Medicine for his contribution to modern cancer epidemiology. He was also awarded honorary degree
Honorary degree
An honorary degree or a degree honoris causa is an academic degree for which a university has waived the usual requirements, such as matriculation, residence, study, and the passing of examinations...

s by thirteen different universities
University
A university is an institution of higher education and research, which grants academic degrees in a variety of subjects. A university is an organisation that provides both undergraduate education and postgraduate education...

.

He died on 24 July 2005, at the John Radcliffe Hospital
John Radcliffe Hospital
The John Radcliffe Hospital is a large tertiary teaching hospital in Oxford, England.It is the main teaching hospital for Oxford University and Oxford Brookes University. As such, it is a well-developed centre of medical research. It also incorporates the Medical School of the University of Oxford....

 in Oxford
Oxford
The city of Oxford is the county town of Oxfordshire, England. The city, made prominent by its medieval university, has a population of just under 165,000, with 153,900 living within the district boundary. It lies about 50 miles north-west of London. The rivers Cherwell and Thames run through...

 after a short illness.

Building

The Richard Doll Building was named in his honour and opened shortly before his death.
It currently houses the
Clinical Trial Service Unit
Clinical Trial Service Unit
The Clinical Trial Services Unit is a medical research institute within Oxford University in the United Kingdom.It primarily conducts large scale clinical trials and epidemiological studies of chronic diseases, especially cancer and vascular conditions.It is located in the Richard Doll Building ...

,
Cancer Epidemiology Unit
Cancer Epidemiology Unit
The Cancer Epidemiology Unit is a medical research institute within Oxford University in the United Kingdom. It is located in the Richard Doll building on the Old Road Campus, Oxford.- Major projects :...

 and
National Perinatal Epidemiology Unit.
A plaque inside the building contains the following quotation from Doll:

"Death in old age is inevitable, but death before old age is not. In previous centuries 70 years used to be regarded as humanity's allotted span of life, and only about one in five lived to such an age. Nowadays, however, for non-smokers in Western countries, the situation is reversed: only about one in five will die before 70, and the non-smoker death rates are still decreasing, offering the promise, at least in developed countries, of a world where death before 70 is uncommon. For this promise to be properly realised, ways must be found to limit the vast damage that is now being done by tobacco and to bring home, not only to the many millions of people in developed countries but also the far larger populations elsewhere, the extent to which those who continue to smoke are shortening their expectation of life by so doing."

One of the buildings of the Institute of Cancer Research
Institute of Cancer Research
The Institute of Cancer Research is a cancer research institute located in London, United Kingdom and a constituent college of the federal University of London. The ICR was founded in 1909 as a research department of the Royal Marsden Hospital and joined the University of London in 2003...

 in Sutton, London
Sutton, London
Sutton is a large suburban town in southwest London, England, and the administrative headquarters of the London Borough of Sutton. It is located south-southwest of Charing Cross and is one of the major metropolitan centres identified in the London Plan. The town was connected to central London by...

 is also named after Sir Richard Doll.

Controversy

After his death, controversy arose over some of his work because his papers, held at the Wellcome Library
Wellcome Library
The Wellcome Library is founded on the collection formed by Sir Henry Wellcome , whose personal wealth allowed him to create one of the most ambitious collections of the 20th century. Henry Wellcome's interest was the history of medicine in a broad sense and included subjects like alchemy or...

, showed that for many years he had received consultancy payments from chemical companies whose products he was to defend in court. These include US$1,500 per day consultancy fee from Monsanto Company for a relationship which began in 1976 and continued until 2002. He also received fees from the Chemical Manufacturers Association, Dow Chemicals
Dow Chemical Company
The Dow Chemical Company is a multinational corporation headquartered in Midland, Michigan, United States. As of 2007, it is the second largest chemical manufacturer in the world by revenue and as of February 2009, the third-largest chemical company in the world by market capitalization .Dow...

, and ICI
Imperial Chemical Industries
Imperial Chemical Industries was a British chemical company, taken over by AkzoNobel, a Dutch conglomerate, one of the largest chemical producers in the world. In its heyday, ICI was the largest manufacturing company in the British Empire, and commonly regarded as a "bellwether of the British...

. Some donations, including a £50,000 gift from asbestos company Turner and Newall, were given in public ceremony to Green College, Oxford
Green College, Oxford
Green College was a graduate college of the University of Oxford in England. It was centred around an architecturally appealing 18th century building: the Radcliffe Observatory, which is modelled after the ancient "Tower of the Winds" in Athens....

 where his wife was Warden , but most fees and payments remained undisclosed to the public, Oxford University and colleagues until his death. His defenders point out that his connections to industry were widely known by those in the field, that he did his work before formal disclosure of commercial interests became commonplace and that on occasion, he came to conclusions that were unpalatable to the companies who consulted him. His own view, as reported by Richard Peto
Richard Peto
Sir Richard Peto FRS is Professor of Medical Statistics and Epidemiology at the University of Oxford.He attended Taunton's School in Southampton and subsequently studied Natural Sciences at Cambridge University....

, was that it was necessary to co-operate with companies for access to data which could prove their products to be dangerous.

Doll caused controversy in 2001 when he said in a BBC radio interview that "the effects of other people smoking in my presence is so small it doesn't worry me”.

External links

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