The oldest descriptions of cancer date back to Egypt, at about 1600 BC. The so-called Edwin Smith Papyrus describes eight cases of what appears to be breast cancer. The tumors of the breast were treated by cauterization, with a tool called "the fire drill."

The first occupational association with cancer was noted in 1700 with the observation that nuns had an elevated incidence of breast cancer. In 1775, the English physician and surgeon Percivall Pott made the observation that exposure to soot might explain the high incidence of scrotum cancer in chimney sweeps. This was the first indication that exposure to chemicals, in this case a complex mixture, could cause cancer. However, this new knowledge did not immediately translate into improved working conditions for chimney sweeps. Over 100 years later it was observed that cancer of the scrotum was rare in continental Europe but still high in England, possibly due to better hygiene practices in Europe. We still have not taken to heart the cancerous consequences of exposure to smoke and tar, as ongoing consumption of tobacco products clearly shows. (Photo: chimney sweep in the 1850s.)

The industrial revolution of the late 19th and early 20th centuries brought clear confirmation that occupational exposure to chemicals could cause cancer. The first indication came from increases in skin and bladder cancers associated with cutting oils and dyes. In 1895, bladder cancer was associated with workers in the aniline dye industry. Further worker-based studies found that exposure to specific chemicals could be responsible for the cancer. In 1915, Japanese researchers reported that they could induce skin tumors in animals by repeatedly applying a coal tar solution to the skin of rabbits. These early studies, subsequently repeated with mice, ushered in the scientific investigation of the chemical causes of cancer. These studies also initiated the systematic investigation of the adverse health effects of chemicals, which in many ways laid the foundation for the toxicological sciences.

But chemicals are not the only cause of cancer. Marie Curie, awarded Nobel Prizes in both physics and chemistry, discovered radium in 1898. The green glow of radium fascinated people, and many thought it was a cure for many diseases, including cancer. The carcinogenicity of radium became tragically apparent when young women developed bone cancer from painting watch dials with radium. The use of nuclear weapons by the U.S. military in World War II, and subsequent development of the defense and nuclear industries in various countries, have raised public awareness of the health consequences of radiation exposure. Naturally occurring background radiation, as well as our many medical and industrial exposures to radiation, is responsible for some cancers. (Photo: Marie Curie in 1911.)

More recent research has broadened our understanding of cancer's causes. Epidemiology studies of various human populations indicated that inorganic metals such as arsenic and nickel could cause cancer; this was subsequently confirmed in animal studies. Various hormones are implicated in organ-specific cancer, such as breast cancer. Nutrition and diet also appear to be related to cancer, specifically high caloric intake. The grain contaminant aflatoxin B1 is known to cause liver cancer.

Chemical mixtures or exposure to multiple agents can increase the incidence of cancer; for example, smoking and asbestos exposure increase the likelihood of lung cancer. And finally, we are now learning that our genetic makeup increases the likelihood that certain cancers will develop. For example, breast cancer is linked to specific genes.

Selected History of Cancer

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