Brian MacMahon

Infobox_Scientist
name = Brian MacMahon


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birth_date = August 23, 1923
birth_place = Sheffield, UK
death_date = December 5, 2007
death_place = Boston, MA, USA
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nationality = British, US
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field = Epidemiology
work_institution = Harvard School of Public Health, USA
alma_mater = University of Birmingham, UK
doctoral_advisor =
doctoral_students =
known_for = Breast cancer epidemiology
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Brian MacMahon (23 August 1923 – 5 December 2007) 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.

Personal life

MacMahon was born in Sheffield, UK. His father was a professional violinist. [http://www.boston.com/bostonglobe/obituaries/articles/2007/12/09/brian_macmahon_an_epidemiologist_at_84/?page=1 Marquard B. Brian MacMahon, an epidemiologist; at 84. "Boston Globe", 9 December 2007] (accessed 30 January 2008)] 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. [http://www.hsph.harvard.edu/now/20080104/macmahon.html Anon. In memoriam: Brian MacMahon. "Harvard Public Health NOW" (4 January 2008)] (accessed 30 January 2008)]

He died at Boston, Massachusetts, USA in 2007, following a stroke.

Education and early career

MacMahon studied medicine at the University of Birmingham, gaining the diplomas of the Royal College of Physicians and Royal College of Surgeons in 1946, and the MB BChir in 1948. [http://www.epidem.com/pt/re/epidemiology/fulltext.00001648-200407000-00019.htm Willett W. (2004) A conversation with Brian MacMahon. "Epidemiology" 15: 504–508] (accessed 30 January 2008)] 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.Oransky I. (2008) Brian MacMahon. "Lancet" 371: 112] 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.

Career in epidemiology

MacMahon's early academic positions were 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. [http://www.nytimes.com/2007/08/21/nyregion/21clark.html?n=Top/Reference/Times%20Topics/Subjects/D/Deaths%20(Obituaries) Pearce J. Dr. Duncan W. Clark, voice for fluoridated water, dies at 96. "New York Times" (21 August 2007)] (accessed 30 January 2008)]

Research

Breast cancer

MacMahon was unusual in focusing on the epidemiology of chronic diseases, in particular cancer, 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. [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)] 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%. [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)] 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 [MacMahon B, Trichopoulos D, Brown J "et al". (1982) Age at menarche, urine estrogens and breast cancer risk. "Int J Cancer" 30: 427–431 (PMID 7141738)] and menopause, [Trichopoulos D, MacMahon B, Cole P. (1972) Menopause and breast cancer risk. "J Natl Cancer Inst" 48: 605–613 (PMID 5058966)] lactation, [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) ( [https://content.nejm.org/cgi/content/full/330/2/81 full text] )] alcohol consumption [Longnecker MP, Newcomb PA, Mittendorf R "et al". (1995) Risk of breast cancer in relation to lifetime alcohol consumption. "J Natl Cancer Inst" 87: 923–929 (PMID 7666482)] and diet. [Katsouyanni K, Trichopoulos D, Boyle P "et al". (1986) Diet and breast cancer: a case-control study in Greece. "Int J Cancer" 38: 815–820 (PMID 3793261)]

Other cancers

With Dimitrios Trichopoulos, MacMahon pioneered research into the association of passive smoking 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. [Trichopoulos D, Kalandidi A, Sparros L, MacMahon B. (1981) Lung cancer and passive smoking. "Int J Cancer" 27: 1–4 (PMID 7251227)]

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 [MacMahon B, Yen S, Trichopoulos D "et al". (1981) Coffee and cancer of the pancreas. "N Engl J Med" 304: 630–633 (PMID 7453739)] provoked a storm of protest from coffee drinkers and industry groups, with coverage in the "New York Times", "Time" magazine and "Newsweek". [http://www.epimonitor.net/EpiWitWisdom/interviews1.htm Epimonitor: Coffee and pancreatic cancer: an interview with Brian MacMahon] (accessed 31 January 2008)] [http://heartland.temp.siteexecutive.com/pdf/23134v.pdf Lieberman AJ. (1997) Facts versus fears: a review of the 20 greatest unfounded health scares of recent times. pp. 18–19 (American Council on Science and Health)] (accessed 1 February 2008)] [ [http://www.time.com/time/magazine/article/0,9171,952951,00.html Anon. Coffee nerves. "Time" (23 March 1981)] (accessed 1 February 2008)] 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. [MacMahon B. (1957) Epidemiological evidence on the nature of Hodgkin's disease. "Cancer" 10: 1045–1054 (PMID 13472655)]

Other diseases

MacMahon worked extensively on pyloric stenosis 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. [MacMahon B. (2006) The continuing enigma of pyloric stenosis of infancy: a review. "Epidemiology" 17: 195–201 (PMID 16477261)]

Awards

*National Divisional Distinguished Service Award - awarded by the American Cancer Society in 1971
*John Snow Award - awarded by the American Public Health Association in 1980
*Donald Reid Medal - awarded for services to epidemiology in 1987 by the London School of Hygiene and Tropical Medicine.
*Charles S. Mott Prize - awarded by the General Motors Cancer Research Foundation for his work on the epidemiology of cancer (1992).
*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.

Key publications

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) ( [https://content.nejm.org/cgi/content/full/330/2/81 full text] )

References