Brian MacMahon
Encyclopedia
Brian MacMahon was a British-American epidemiologist
who chaired the Harvard School of Public Health
from 1958 until 1988. Best known for his work on the epidemiology of breast cancer
, he also pioneered research on associations between passive smoking
and lung cancer
, and between diet
and risk of cancer.
, UK. His father was a professional violinist. In 1948, he married Heidi Marie Graber from Switzerland
(who died in 2001); the couple had two sons and two daughters. He emigrated to the USA in the late 1950s, and became a US citizen in 1962.
He died at Boston, Massachusetts, USA in 2007, following a stroke
.
, gaining the diplomas of the Royal College of Physicians
and Royal College of Surgeons in 1946, and the MB BChir
in 1948. After working as a locum doctor in impoverished areas of Birmingham
, MacMahon served as a ship's doctor in the British Merchant Navy from 1946 to 1948. He later said that these experiences left him "somewhat dispirited about a future in clinical medicine".
Enrolment in a course in public health
at the University of Birmingham brought him into contact with epidemiologists Thomas McKeown, Ronald Lowe and Reginald Record, who became his supervisors in a PhD
in "social medicine" (as epidemiology was then known) studying infantile pyloric stenosis
. After gaining his PhD in 1952, he travelled to the USA to obtain a Master's
in epidemiology at the Harvard School of Public Health
(1953). In 1955, he gained the MD
degree at the University of Birmingham.
, UK, and at the Department of Environmental Medicine and Community Health at the State University of New York
in Brooklyn
, USA, where he worked with Duncan Clark
, focusing on the epidemiology of leukemia
and breast cancer
.
In 1958, he was appointed head of the Harvard School of Public Health
, USA, a position he held until his retirement in 1988. In 1976, he was appointed the Henry Pickering Walcott Professor of Epidemiology at the school, and he also served as the Associate Dean (1977–8). From 1974, he held a professorship in public health at the University of Hawaii at Manoa
. MacMahon built the Harvard School of Public Health into a world-class research institution; he particularly prided himself, however, on nurturing students, many of whom went on to become leaders in the field of epidemiology. Well-known former students include Dimitrios Trichopoulos and Walter Willett
.
MacMahon co-authored the textbook Epidemiologic Methods (1960), later reissued as Epidemiology: Principles and Methods, with Thomas Pugh. Described by Willett as "the first modern epidemiology textbook", it became a standard text in the subject. He also co-edited Preventive Medicine (1967), later republished as Preventive and Community Medicine, with Duncan Clark.
, at a time when most epidemiologists concentrated on infectious diseases. His most widely known research relates to breast cancer
. An international study, published in 1970, on which MacMahon was the lead author showed for the first time that the age at which a woman first gives birth significantly affects her risk of later developing breast cancer; giving birth at a young age was found to be protective. Subsequent work by MacMahon's group showed that every year a woman delays giving birth after the age of eighteen increases her risk of developing breast cancer by 3.5%. The 1970 study stimulated later research into hormonal causes of breast cancer.
MacMahon's group also studied other factors associated with breast cancer risk, including age at menarche
and menopause
, lactation
, alcohol
consumption and diet
.
with lung cancer
. Their study showed that non-smoking women whose husbands smoked heavily (more than a pack per day) had a greater than threefold increased risk of developing lung cancer.
He was also one of the first to study the effect of diet
on cancer; this work was continued by his student Walter Willett
. This research was not without controversy: a case-control study which unexpectedly linked coffee
drinking with increased risk of pancreatic cancer
provoked a storm of protest from coffee drinkers and industry groups, with coverage in the New York Times, Time magazine and Newsweek. Academic criticism focused on the study's choice of controls. Subsequent studies, including one by MacMahon's group, failed to confirm the association.
He also studied Hodgkin's lymphoma
, providing evidence that the disease might be caused by more than one agent.
of infants. His work focused attention on the effect of environmental factors on this disease.
Despite developing Dupuytren's contracture
in his hands, which hindered computer use, MacMahon remained active in research long after his official retirement, for example, contributing a final review on pyloric stenosis in 2006.
(1971), the John Snow Award of the American Public Health Association
(1980), the Donald Reid Medal
of the London School of Hygiene and Tropical Medicine (1987), and the Charles S. Mott Prize
of the General Motors
Cancer Research Foundation for his work on the epidemiology of cancer
(1992). He was elected as a member of the Institute of Medicine
in 1973. He has received honorary doctorates from the University of Birmingham
, University of Athens
and the State University of New York
.
Epidemiology
Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...
who chaired the Harvard School of Public Health
Harvard School of Public Health
The Harvard School of Public Health is one of the professional graduate schools of Harvard University, located in the Longwood Area of the Boston, Massachusetts neighborhood of Mission Hill, which is next to Harvard Medical School. HSPH is considered a significant school focusing on health in the...
from 1958 until 1988. Best known for his work on the epidemiology of 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...
, he also pioneered research on associations between passive smoking
Passive smoking
Passive smoking is the inhalation of smoke, called secondhand smoke or environmental tobacco smoke , from tobacco products used by others. It occurs when tobacco smoke permeates any environment, causing its inhalation by people within that environment. Exposure to secondhand tobacco smoke causes...
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 between diet
Diet (nutrition)
In nutrition, diet is the sum of food consumed by a person or other organism. Dietary habits are the habitual decisions an individual or culture makes when choosing what foods to eat. With the word diet, it is often implied the use of specific intake of nutrition for health or weight-management...
and risk of cancer.
Personal life
MacMahon was born in SheffieldSheffield
Sheffield is a city and metropolitan borough of South Yorkshire, England. Its name derives from the River Sheaf, which runs through the city. Historically a part of the West Riding of Yorkshire, and with some of its southern suburbs annexed from Derbyshire, the city has grown from its largely...
, UK. His father was a professional violinist. In 1948, he married Heidi Marie Graber from Switzerland
Switzerland
Switzerland name of one of the Swiss cantons. ; ; ; or ), in its full name the Swiss Confederation , is a federal republic consisting of 26 cantons, with Bern as the seat of the federal authorities. The country is situated in Western Europe,Or Central Europe depending on the definition....
(who died in 2001); the couple had two sons and two daughters. He emigrated to the USA in the late 1950s, and became a US citizen in 1962.
He died at Boston, Massachusetts, USA in 2007, following a stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
.
Education and early career
MacMahon studied medicine at the University of BirminghamUniversity of Birmingham
The University of Birmingham is a British Redbrick university located in the city of Birmingham, England. It received its royal charter in 1900 as a successor to Birmingham Medical School and Mason Science College . Birmingham was the first Redbrick university to gain a charter and thus...
, gaining the diplomas of 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...
and Royal College of Surgeons in 1946, and the MB BChir
Bachelor of Medicine and Surgery
Bachelor of Medicine, Bachelor of Surgery, or in Latin Medicinae Baccalaureus, Baccalaureus Chirurgiae , are the two first professional degrees awarded upon graduation from medical school in medicine and surgery by universities in various countries...
in 1948. After working as a locum doctor in impoverished areas of Birmingham
Birmingham
Birmingham is a city and metropolitan borough in the West Midlands of England. It is the most populous British city outside the capital London, with a population of 1,036,900 , and lies at the heart of the West Midlands conurbation, the second most populous urban area in the United Kingdom with a...
, MacMahon served as a ship's doctor in the British Merchant Navy from 1946 to 1948. He later said that these experiences left him "somewhat dispirited about a future in clinical medicine".
Enrolment in a course in public health
Public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
at the University of Birmingham brought him into contact with epidemiologists Thomas McKeown, Ronald Lowe and Reginald Record, who became his supervisors in a PhD
PHD
PHD may refer to:*Ph.D., a doctorate of philosophy*Ph.D. , a 1980s British group*PHD finger, a protein sequence*PHD Mountain Software, an outdoor clothing and equipment company*PhD Docbook renderer, an XML renderer...
in "social medicine" (as epidemiology was then known) studying infantile pyloric stenosis
Pyloric stenosis
Pyloric stenosis is a condition that causes severe vomiting in the first few months of life. There is narrowing of the opening from the stomach to the intestines, due to enlargement of the muscle surrounding this opening , which spasms when the stomach empties...
. After gaining his PhD in 1952, he travelled to the USA to obtain a Master's
Master's degree
A master's is an academic degree granted to individuals who have undergone study demonstrating a mastery or high-order overview of a specific field of study or area of professional practice...
in epidemiology at the Harvard School of Public Health
Harvard School of Public Health
The Harvard School of Public Health is one of the professional graduate schools of Harvard University, located in the Longwood Area of the Boston, Massachusetts neighborhood of Mission Hill, which is next to Harvard Medical School. HSPH is considered a significant school focusing on health in the...
(1953). In 1955, he gained the MD
Doctor of Medicine
Doctor of Medicine is a doctoral degree for physicians. The degree is granted by medical schools...
degree at the University of Birmingham.
Career in epidemiology
MacMahon's early academic positions were at the University of BirminghamUniversity of Birmingham
The University of Birmingham is a British Redbrick university located in the city of Birmingham, England. It received its royal charter in 1900 as a successor to Birmingham Medical School and Mason Science College . Birmingham was the first Redbrick university to gain a charter and thus...
, UK, and at the Department of Environmental Medicine and Community Health at the State University of New York
State University of New York
The State University of New York, abbreviated SUNY , is a system of public institutions of higher education in New York, United States. It is the largest comprehensive system of universities, colleges, and community colleges in the United States, with a total enrollment of 465,000 students, plus...
in Brooklyn
Brooklyn
Brooklyn is the most populous of New York City's five boroughs, with nearly 2.6 million residents, and the second-largest in area. Since 1896, Brooklyn has had the same boundaries as Kings County, which is now the most populous county in New York State and the second-most densely populated...
, USA, where he worked with Duncan Clark
Duncan Clark
Duncan William Clark, MD was an American public health expert and preventive medicine specialist. He is best known for advocating the addition of fluoride to the New York City's water supply to prevent tooth decay.-Education:...
, focusing on the epidemiology of 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...
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...
.
In 1958, he was appointed head of the Harvard School of Public Health
Harvard School of Public Health
The Harvard School of Public Health is one of the professional graduate schools of Harvard University, located in the Longwood Area of the Boston, Massachusetts neighborhood of Mission Hill, which is next to Harvard Medical School. HSPH is considered a significant school focusing on health in the...
, USA, a position he held until his retirement in 1988. In 1976, he was appointed the Henry Pickering Walcott Professor of Epidemiology at the school, and he also served as the Associate Dean (1977–8). From 1974, he held a professorship in public health at the University of Hawaii at Manoa
University of Hawaii at Manoa
The University of Hawaii at Mānoa is a public, co-educational university and is the flagship campus of the greater University of Hawaii system...
. MacMahon built the Harvard School of Public Health into a world-class research institution; he particularly prided himself, however, on nurturing students, many of whom went on to become leaders in the field of epidemiology. Well-known former students include Dimitrios Trichopoulos and Walter Willett
Walter Willett
Walter Willett, MD, DrPH., is an American physician and nutrition researcher. Currently, Willett is the Fredrick John Stare Professor of Epidemiology and Nutrition, and Chair of the Department of Nutrition at Harvard School of Public Health...
.
MacMahon co-authored the textbook Epidemiologic Methods (1960), later reissued as Epidemiology: Principles and Methods, with Thomas Pugh. Described by Willett as "the first modern epidemiology textbook", it became a standard text in the subject. He also co-edited Preventive Medicine (1967), later republished as Preventive and Community Medicine, with Duncan Clark.
Breast cancer
MacMahon was unusual in focusing on the epidemiology of chronic diseases, in particular cancerCancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
, at a time when most epidemiologists concentrated on infectious diseases. His most widely known research relates to 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...
. An international study, published in 1970, on which MacMahon was the lead author showed for the first time that the age at which a woman first gives birth significantly affects her risk of later developing breast cancer; giving birth at a young age was found to be protective. Subsequent work by MacMahon's group showed that every year a woman delays giving birth after the age of eighteen increases her risk of developing breast cancer by 3.5%. The 1970 study stimulated later research into hormonal causes of breast cancer.
MacMahon's group also studied other factors associated with breast cancer risk, including age at menarche
Menarche
Menarche is the first menstrual cycle, or first menstrual bleeding, in female human beings. From both social and medical perspectives it is often considered the central event of female puberty, as it signals the possibility of fertility....
and menopause
Menopause
Menopause is a term used to describe the permanent cessation of the primary functions of the human ovaries: the ripening and release of ova and the release of hormones that cause both the creation of the uterine lining and the subsequent shedding of the uterine lining...
, lactation
Lactation
Lactation describes the secretion of milk from the mammary glands and the period of time that a mother lactates to feed her young. The process occurs in all female mammals, however it predates mammals. In humans the process of feeding milk is called breastfeeding or nursing...
, 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....
consumption and diet
Diet (nutrition)
In nutrition, diet is the sum of food consumed by a person or other organism. Dietary habits are the habitual decisions an individual or culture makes when choosing what foods to eat. With the word diet, it is often implied the use of specific intake of nutrition for health or weight-management...
.
Other cancers
With Dimitrios Trichopoulos, MacMahon pioneered research into the association of passive smokingPassive smoking
Passive smoking is the inhalation of smoke, called secondhand smoke or environmental tobacco smoke , from tobacco products used by others. It occurs when tobacco smoke permeates any environment, causing its inhalation by people within that environment. Exposure to secondhand tobacco smoke causes...
with 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...
. Their study showed that non-smoking women whose husbands smoked heavily (more than a pack per day) had a greater than threefold increased risk of developing lung cancer.
He was also one of the first to study the effect of diet
Diet (nutrition)
In nutrition, diet is the sum of food consumed by a person or other organism. Dietary habits are the habitual decisions an individual or culture makes when choosing what foods to eat. With the word diet, it is often implied the use of specific intake of nutrition for health or weight-management...
on cancer; this work was continued by his student Walter Willett
Walter Willett
Walter Willett, MD, DrPH., is an American physician and nutrition researcher. Currently, Willett is the Fredrick John Stare Professor of Epidemiology and Nutrition, and Chair of the Department of Nutrition at Harvard School of Public Health...
. This research was not without controversy: a case-control study which unexpectedly linked coffee
Coffee
Coffee is a brewed beverage with a dark,init brooo acidic flavor prepared from the roasted seeds of the coffee plant, colloquially called coffee beans. The beans are found in coffee cherries, which grow on trees cultivated in over 70 countries, primarily in equatorial Latin America, Southeast Asia,...
drinking with increased risk of pancreatic cancer
Pancreatic cancer
Pancreatic cancer refers to a malignant neoplasm of the pancreas. The most common type of pancreatic cancer, accounting for 95% of these tumors is adenocarcinoma, which arises within the exocrine component of the pancreas. A minority arises from the islet cells and is classified as a...
provoked a storm of protest from coffee drinkers and industry groups, with coverage in the New York Times, Time magazine and Newsweek. Academic criticism focused on the study's choice of controls. Subsequent studies, including one by MacMahon's group, failed to confirm the association.
He also studied Hodgkin's lymphoma
Hodgkin's lymphoma
Hodgkin's lymphoma, previously known as Hodgkin's disease, is a type of lymphoma, which is a cancer originating from white blood cells called lymphocytes...
, providing evidence that the disease might be caused by more than one agent.
Other diseases
MacMahon worked extensively on pyloric stenosisPyloric stenosis
Pyloric stenosis is a condition that causes severe vomiting in the first few months of life. There is narrowing of the opening from the stomach to the intestines, due to enlargement of the muscle surrounding this opening , which spasms when the stomach empties...
of infants. His work focused attention on the effect of environmental factors on this disease.
Despite developing Dupuytren's contracture
Dupuytren's contracture
Dupuytren's contracture , is a fixed flexion contracture of the hand where the fingers bend towards the palm and cannot be fully extended...
in his hands, which hindered computer use, MacMahon remained active in research long after his official retirement, for example, contributing a final review on pyloric stenosis in 2006.
Awards
MacMahon has been awarded the National Divisional Distinguished Service Award of the American Cancer SocietyAmerican Cancer Society
The American Cancer Society is the "nationwide community-based voluntary health organization" dedicated, in their own words, "to eliminating cancer as a major health problem by preventing cancer, saving lives, and diminishing suffering from cancer, through research, education, advocacy, and...
(1971), the John Snow Award of the American Public Health Association
American Public Health Association
The American Public Health Association is Washington, D.C.-based professional organization for public health professionals in the United States. Founded in 1872 by Dr. Stephen Smith, APHA has more than 30,000 members worldwide...
(1980), the Donald Reid Medal
Donald Reid Medal
The Donald Reid Medal is awarded triennially by the London School of Hygiene and Tropical Medicine in recognition of distinguished contributions to epidemiology.-Institution:...
of the London School of Hygiene and Tropical Medicine (1987), and the Charles S. Mott Prize
Charles S. Mott Prize
The $250,000 Charles S. Mott Prize was awarded annually by the General Motors Cancer Research Foundation. The Mott Prize was one of a trio scientific prizes entirely devoted to cancer research . They were generally considered the most prestigious awards in cancer research...
of the General Motors
General Motors
General Motors Company , commonly known as GM, formerly incorporated as General Motors Corporation, is an American multinational automotive corporation headquartered in Detroit, Michigan and the world's second-largest automaker in 2010...
Cancer Research Foundation for his work on the epidemiology of cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
(1992). He was elected as a member of the Institute of Medicine
Institute of Medicine
The Institute of Medicine is a not-for-profit, non-governmental American organization founded in 1970, under the congressional charter of the National Academy of Sciences...
in 1973. He has received honorary doctorates from the University of Birmingham
University of Birmingham
The University of Birmingham is a British Redbrick university located in the city of Birmingham, England. It received its royal charter in 1900 as a successor to Birmingham Medical School and Mason Science College . Birmingham was the first Redbrick university to gain a charter and thus...
, University of Athens
National and Kapodistrian University of Athens
The National and Kapodistrian University of Athens , usually referred to simply as the University of Athens, is the oldest university in Southeast Europe and has been in continuous operation since its establishment in 1837. Today, it is the second-largest institution of higher learning in Greece,...
and the State University of New York
State University of New York
The State University of New York, abbreviated SUNY , is a system of public institutions of higher education in New York, United States. It is the largest comprehensive system of universities, colleges, and community colleges in the United States, with a total enrollment of 465,000 students, plus...
.
Books
- MacMahon B, Pugh TF. Epidemiologic Methods (Little, Brown; 1960); reissued as Epidemiology: Principles and Methods (Little, Brown; 1970) (ISBN 0316542598)
Research papers
- McKeown T, MacMahon B. (1955) Infantile pyloric stenosis in parent and child. Arch Dis Child 30: 497–500 (PMID 13275979)
- MacMahon B, Cole P, Lin TM et al.. (1970) Age at first birth and breast cancer risk. Bull World Health Organ 43: 209–221 (PMID 5312521)
- Trichopoulos D, Kalandidi A, Sparros L, MacMahon B. (1981) Lung cancer and passive smoking. Int J Cancer 27: 1–4 (PMID 7251227)
- MacMahon B, Yen S, Trichopoulos D et al.. (1981) Coffee and cancer of the pancreas. N Engl J Med 304: 630–633 (PMID 7453739)
- Trichopoulos D, Hsieh CC, MacMahon B et al.. (1983) Age at any birth and breast cancer risk. Int J Cancer 31: 701–704 (PMID 6862681)
- Newcomb PA, Storer BE, Longnecker MP et al.. (1994) Lactation and a reduced risk of premenopausal breast cancer. N Engl J Med 330: 81–87 (PMID 8259187) (full text)