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Early 1900's, when smoking was gaining popularity in England, it was not known that smoking caused lung cancer. Lung cancer was so widespread in 1930's, that it was the 2nd most frequent cause of death (exceeded only by death in military, because of WW 1 and 2).
Richard Doll, and Bradford Hill, epidemiologists for Medical Research Council (MRC). MRC was concerned about lung cancer rates, so they asked Doll and Hill to perform study.
Doll/Hill went to hospitals and visited patients in London hospitals, who had been diagnosed with or suspected of lung cancer, gave them questionnaire (about family history, diet, previous diseases, if they had worked on roads). Doll had a suspicion that lung cancer was caused by tarring of roads, but the most believed cause at time was atmospheric pollution. Results (after few months): if they were a heavy smoker, diagnosis would not change, if nonsmoker, diagnosis almost always changed. In 649 cases of lung cancer, there were two non-smokers. Association/causation?
MRC suggested that results might have only applied to London, so Doll and Hill conducted same type of survey in 4 other neighboring cities, in a bigger, wider survey. Results were same, but did not get much attention.
Doll/Hill decided to do new study, of lung cancer in doctors. They wrote to/ asked more than 40,000 doctors about smoking habits, and their health was monitored over following years (1951-1954). Results were same, and attention was given, because doctors were studied; printed in British Med. Journal.
