Ernst Wynder
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Ernst Ludwig Wynder (April 30, 1922 – July 14, 1999) was an American
epidemiology Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population. It is a cornerstone of public health, and shapes policy decisions and evidenc ...
and
public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the det ...
researcher who studied the health effects of smoking tobacco. His and
Evarts Ambrose Graham Evarts Ambrose Graham (1883–1957) was an American academic, physician, and surgeon. Early years and military service Born in Chicago, Illinois to a surgeon, Dr. David Wilson Graham, and Ida Ansbach Barned Graham, Evarts attended college at Prin ...
's joint publication of "Tobacco Smoking as a Possible Etiologic Factor in Bronchiogenic Carcinoma: A Study of 684 Proved Cases" appeared in the
Journal of the American Medical Association ''The Journal of the American Medical Association'' (''JAMA'') is a peer-reviewed medical journal published 48 times a year by the American Medical Association. It publishes original research, reviews, and editorials covering all aspects of bio ...
. It was one of the first major scientific publications to identify smoking as a contributory cause of
lung cancer Lung cancer, also known as lung carcinoma (since about 98–99% of all lung cancers are carcinomas), is a malignant lung tumor characterized by uncontrolled cell growth in tissue (biology), tissues of the lung. Lung carcinomas derive from tran ...
.


Biography

Wynder was born in
Herford Herford (; nds, Hiarwede) is a town in North Rhine-Westphalia, Germany, located in the lowlands between the hill chains of the Wiehen Hills and the Teutoburg Forest. It is the capital of the district of Herford (district), Herford. Geography ...
,
Westphalia Westphalia (; german: Westfalen ; nds, Westfalen ) is a region of northwestern Germany and one of the three historic parts of the state of North Rhine-Westphalia. It has an area of and 7.9 million inhabitants. The territory of the regio ...
in 1922 to
Jewish Jews ( he, יְהוּדִים, , ) or Jewish people are an ethnoreligious group and nation originating from the Israelites Israelite origins and kingdom: "The first act in the long drama of Jewish history is the age of the Israelites""The ...
parents (a cousin of Robert Weinberg). In 1938 his family escaped
Nazi Nazism ( ; german: Nazismus), the common name in English for National Socialism (german: Nationalsozialismus, ), is the far-right totalitarian political ideology and practices associated with Adolf Hitler and the Nazi Party (NSDAP) in ...
rule and fled to the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territorie ...
, where Wynder enrolled at
New York University New York University (NYU) is a private research university in New York City. Chartered in 1831 by the New York State Legislature, NYU was founded by a group of New Yorkers led by then-Secretary of the Treasury Albert Gallatin. In 1832, the ...
. During
World War II World War II or the Second World War, often abbreviated as WWII or WW2, was a world war that lasted from 1939 to 1945. It involved the vast majority of the world's countries—including all of the great powers—forming two opposin ...
, he attained citizenship and joined the U.S. Army, where, as a German-speaker, he was assigned to a
psychological warfare Psychological warfare (PSYWAR), or the basic aspects of modern psychological operations (PsyOp), have been known by many other names or terms, including Military Information Support Operations (MISO), Psy Ops, political warfare, "Hearts and Mi ...
unit to monitor German newscasts. After the war, he attended medical school at
Washington University in St. Louis Washington University in St. Louis (WashU or WUSTL) is a private research university with its main campus in St. Louis County, and Clayton, Missouri. Founded in 1853, the university is named after George Washington. Washington University is r ...
. In 1950, he received both a
Bachelor of Science A Bachelor of Science (BS, BSc, SB, or ScB; from the Latin ') is a bachelor's degree awarded for programs that generally last three to five years. The first university to admit a student to the degree of Bachelor of Science was the University of ...
and a medical degree. Aside from his credentials as a physician, Wynder was a researcher, educator, and activist. He devoted his career to the study and prevention of cancer and
chronic disease A chronic condition is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term ''chronic'' is often applied when the course of the disease lasts for more than three mo ...
, publishing hundreds of scientific papers. Through the 1950s and 1960s, he worked at
Sloan-Kettering Institute for Cancer Research Memorial Sloan Kettering Cancer Center (MSK or MSKCC) is a cancer treatment and research institution in the borough of Manhattan in New York City, founded in 1884 as the New York Cancer Hospital. MSKCC is one of 52 National Cancer Institute– ...
. In 1969, he founded the American Health Foundation. In 1972, he founded the academic journal ''
Preventive Medicine Preventive healthcare, or prophylaxis, consists of measures taken for the purposes of disease prevention.Hugh R. Leavell and E. Gurney Clark as "the science and art of preventing disease, prolonging life, and promoting physical and mental hea ...
'' and served as the founding editor. Wynder died from
thyroid cancer Thyroid cancer is cancer that develops from the tissues of the thyroid gland. It is a disease in which cells grow abnormally and have the potential to spread to other parts of the body. Symptoms can include swelling or a lump in the neck. C ...
on July 14, 1999.


Scholarship


Smoking and Lung Cancer Studies

Wynder began collaborating with his coauthor on the article,
Evarts Ambrose Graham Evarts Ambrose Graham (1883–1957) was an American academic, physician, and surgeon. Early years and military service Born in Chicago, Illinois to a surgeon, Dr. David Wilson Graham, and Ida Ansbach Barned Graham, Evarts attended college at Prin ...
, as a medical student at Washington University in St. Louis in 1947. The previous summer he had conducted epidemiological studies of smoking behavior among 146 lung cancer patients in New York City. The project was funded by the
American Cancer Society The American Cancer Society (ACS) is a nationwide voluntary health organization dedicated to eliminating cancer. Established in 1913, the society is organized into six geographical regions of both medical and lay volunteers operating in more than ...
. Now, with Graham, Wynder collected extensive data on 604 patients with lung cancer at hospitals across the United States. Departing from a tradition of using anecdotal evidence (e.g., clinical interviews) to develop explanations of disease causation, Wynder and Graham applied rudimentary statistical methods to their study. They divided patients into crude categories of "moderate" or "heavy" smokers, based on retrospective interviews of each patient's smoking behavior over a twenty-year period. They also measured and controlled for important confounding factors (e.g., age, types of tobacco use, inhalation level). Most importantly, with regard to an ability to demonstrate causation, Wynder and Graham also studied a control group of cancer-free individuals in hospitals. They systematically compared the lung cancer patients to the control group. On May 27, 1950 the Journal of the
American Medical Association The American Medical Association (AMA) is a professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was approximately 240,000 in 2016. The AMA's state ...
published the resulting scientific report. Incidence among men and women matched patterns of smoking behavior in men and women: "the enormous increase in the sale of cigarettes in this country approximately parallels the increase in ung cancer" As further scientific evidence of smoking's role in causing lung cancer began to accumulate in the United States and Great Britain, Wynder and Graham investigated the
biological plausibility In epidemiology and biomedicine, biological plausibility is the proposal of a causal association—a relationship between a putative cause and an outcome—that is consistent with existing biological and medical knowledge. Biological plausibility ...
of the association between smoking and lung disease. In 1950, they initiated a study of the impact of cigarette tar condensate from tobacco smoke on the skin of mice. After a year of exposure to tar, 44 percent of the mice developed cancers. Wynder also discovered specific
carcinogens A carcinogen is any substance, radionuclide, or radiation that promotes carcinogenesis (the formation of cancer). This may be due to the ability to damage the genome or to the disruption of cellular metabolic processes. Several radioactive substan ...
in tar (e.g., benzopyrenes,
arsenic Arsenic is a chemical element with the symbol As and atomic number 33. Arsenic occurs in many minerals, usually in combination with sulfur and metals, but also as a pure elemental crystal. Arsenic is a metalloid. It has various allotropes, but ...
), but was unable to identify the contributions of these chemicals to cancer. Wynder's studies of tobacco smoke were timely and important. Whereas laboratory studies of tobacco tar had been conducted elsewhere, Wynder's findings supported the growing epidemiological data. "The production of tumors in lab animals offered a powerful indicator that something in cigarette smoke could account for the epidemiological findings," writes Allan M. Brandt, a historian of medicine.


Other Research

Wynder published nearly 800 papers during his lifetime. Wynder's work appeared in 139 periodicals and one book. More than half of his articles were published in ten prestigious mainline journals, such as ''Cancer'', the flagship journal of the
American Cancer Society The American Cancer Society (ACS) is a nationwide voluntary health organization dedicated to eliminating cancer. Established in 1913, the society is organized into six geographical regions of both medical and lay volunteers operating in more than ...
. The dominant themes were lung and
breast cancer Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, milk rejection, fluid coming from the nipple, a newly inverted nipple, or a re ...
, but there were also in-depth studies of the epidemiology of cancer of the
bladder The urinary bladder, or simply bladder, is a hollow organ in humans and other vertebrates that stores urine from the kidneys before disposal by urination. In humans the bladder is a distensible organ that sits on the pelvic floor. Urine enters ...
,
larynx The larynx (), commonly called the voice box, is an organ in the top of the neck involved in breathing, producing sound and protecting the trachea against food aspiration. The opening of larynx into pharynx known as the laryngeal inlet is about ...
, colon and
rectum The rectum is the final straight portion of the large intestine in humans and some other mammals, and the Gastrointestinal tract, gut in others. The adult human rectum is about long, and begins at the rectosigmoid junction (the end of the s ...
,
stomach The stomach is a muscular, hollow organ in the gastrointestinal tract of humans and many other animals, including several invertebrates. The stomach has a dilated structure and functions as a vital organ in the digestive system. The stomach i ...
,
ovary The ovary is an organ in the female reproductive system that produces an ovum. When released, this travels down the fallopian tube into the uterus, where it may become fertilized by a sperm. There is an ovary () found on each side of the body. ...
,
prostate The prostate is both an Male accessory gland, accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found only in some mammals. It differs between species anatomically, ...
,
pancreas The pancreas is an organ of the digestive system and endocrine system of vertebrates. In humans, it is located in the abdomen behind the stomach and functions as a gland. The pancreas is a mixed or heterocrine gland, i.e. it has both an end ...
, and
kidney The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blood ...
, as well as numerous experimental studies. Many of these papers were the first or most comprehensive studies ever published, especially the massive 1960 coauthored study of the epidemiology of breast cancer.


See also

*
Tobacco Tobacco is the common name of several plants in the genus '' Nicotiana'' of the family Solanaceae, and the general term for any product prepared from the cured leaves of these plants. More than 70 species of tobacco are known, but the ...
*
Cigarette A cigarette is a narrow cylinder containing a combustible material, typically tobacco, that is rolled into thin paper for smoking. The cigarette is ignited at one end, causing it to smolder; the resulting smoke is orally inhaled via the opp ...
*
Lung cancer Lung cancer, also known as lung carcinoma (since about 98–99% of all lung cancers are carcinomas), is a malignant lung tumor characterized by uncontrolled cell growth in tissue (biology), tissues of the lung. Lung carcinomas derive from tran ...
*
Evarts Ambrose Graham Evarts Ambrose Graham (1883–1957) was an American academic, physician, and surgeon. Early years and military service Born in Chicago, Illinois to a surgeon, Dr. David Wilson Graham, and Ida Ansbach Barned Graham, Evarts attended college at Prin ...


References and notes


Further reading

* Brandt, Allan. ''The Cigarette Century.'' Basic Books, 2007. * * Gately, Iain. ''Tobacco: A Cultural History of How an Exotic Plant Seduced Civilization.'' Grove Press, 2003. . * Kluger, Richard. ''Ashes to ashes: America's hundred-year cigarette war, the public health, and the unabashed triumph of Philip Morris.'' New York: Knopf, 1996. * Simmons, John Galbraith. ''Doctors and discoveries: lives that created today's medicine: from Hippocrates to the present.'' pp. 307–311. Houghton Mifflin, 2002. . * * * {{DEFAULTSORT:Wynder, Ernst 1922 births 1999 deaths American public health doctors Smoking in the United States Deaths from thyroid cancer United States Army personnel of World War II Medical journal editors Emigrants from Nazi Germany to the United States Deaths from cancer in New York (state) Ritchie Boys New York University alumni Washington University School of Medicine alumni