Cancer in the tropics: geographical pathology and the formation of cancer epidemiology

Abstract

Researchers have long been concerned with cancer in what has been called the tropics, developing world, and low-and middle-income countries. Global health advocates' recent calls to attend to an emergent cancer epidemic in these regions were only the latest effort in this long history. Researchers, known as geographical pathologists, sought to determine the etiologies of cancer and other non-infectious diseases between the 1920s and the 1960s by comparing their occurrence across different environments. The geographical pathologists used the concept of the environment to analyze the influences that natural and artificial surroundings had on health. While the international network of geographical pathology fostered medical thinking about environmental health in the early and mid-twentieth century, the very meaning of environment, alongside the scientific methods for studying the environment, changed in this period. In the 1960s, epidemiology, previously used for the study of infectious diseases, displaced geographical pathology as the cohesive framework of cancer research. This signaled a shift in research focus, from one dedicated to diagnostics and the environment to one centered on population and statistical studies. This article shows that it was not the lack of knowledge about cancer in the developing world but rather specific configurations of knowledge that shaped which cancer interventions in the developing world researchers and public health officials conceived. I confirm that the manuscript is comprised of original material that is not under review elsewhere, and that the studies on which the research is based has been subject to review by the Committee on the Use of Humans as Experimental Subjects (COUHES) of the Massachusetts Institute of Technology.

Cancer and the Politics of Care

“…This distinctive spatial pattern drove aetiological research in the mid-twentieth century, in the hope that geography might offer causal clues and that cracking this specific mystery might illuminate more general mechanisms of cancer causation (Mueller 2019). By the early 1980s, hepatitis B was identified as the main risk factor and a vaccine was on the market, making liver cancer the first 'vaccine-preventable' cancer.…”

Emerging infrastructures: the politics of radium and the validation of radiotherapy in India’s first tertiary cancer hospital

“…Lucas Mueller's (2019) historiography of cancer research from 1920 to 1960 in Kenya further adds to our understandings of how cancer research was modified through time by global biomedical paradigms to maintain legitimization. Mueller shows how the disciplinary shift from geographic pathology to epidemiology in researching cancer "was intended to benefit European and North American scientists at a time of growing alarm over increasing rates of cancer" (Caduff and Van Hollen 2019, p. 4).…”