MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA.
Eur J Epidemiol. 2023 Dec;38(12):1227-1237. doi: 10.1007/s10654-023-01090-5. Epub 2023 Dec 26.
During the early 1980s both cancer biology and epidemiological methods were being transformed. In 1984 the leading cancer epidemiologist Richard Peto - who, in 1981, had published the landmark Causes of Cancer with Richard Doll - wrote a short chapter on "The need for ignorance in cancer research", in which the worlds of epidemiology and speculative Darwinian biology met. His reflections on how evolutionary theory related to cancer have become known as "Peto's paradox", whilst his articulation of "black box epidemiology" provided the logic of subsequent practice in the field. We reprint this sparkling and prescient example of biologically-informed epidemiological theorising at its best in this issue of the European Journal of Epidemiology, together with four commentaries that focus on different aspects of its rich content. Here were provide some contextual background to the 1984 chapter, and our own speculations regarding various paradoxes in cancer epidemiology. We suggest that one reason for the relative lack of progress in indentifying novel modifiable causes of cancer over the last 40 years may reflect such exposures being ubiquitous within environments, and discuss the lessons for epidemiology that would follow from this.
20 世纪 80 年代初，癌症生物学和流行病学方法都在发生转变。1984 年，杰出的癌症流行病学家理查德·皮特（Richard Peto）——他曾在 1981 年与理查德·多尔（Richard Doll）合著里程碑式的《癌症的成因》——在书中写了一章简短的内容，题为“癌症研究需要无知”，将流行病学和推测性达尔文生物学领域联系起来。他关于进化理论与癌症的关系的思考被称为“皮特悖论”，而他对“黑箱流行病学”的阐述为该领域后来的实践提供了逻辑。我们在本期《欧洲流行病学杂志》中重新刊登了这篇具有生物学启发性的流行病学理论的精彩而有先见之明的范例，以及四篇重点关注其丰富内容不同方面的评论。本文为 1984 年的那一章提供了一些背景信息，并对癌症流行病学中的各种悖论进行了我们自己的推测。我们认为，过去 40 年来，在确定新的可改变的癌症病因方面相对缺乏进展的一个原因可能反映了此类暴露在环境中无处不在，并讨论了这对流行病学的启示。
