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568 Statement of -Eleanor J. tdacdonald Professor .°aneritus of Epidemiology Department of Cancer Prevention L'niversity of Texas System Cancer Center M. D. Anderson Hospital and Tumor Institute, Houston, Texas Mv name is Eleanor Macdonald, Professor Emeritus of Epidemiology at the University of Texas System Cancer Center, M.D. anderson Hospital and Tumor Institute, Houston. I have worked in the field of epidemiology for over 40 years in three state programs in Massachusetts, Connecticut and Texas; in fact, I established the first state cancer registry in the U. S. Prcm 1948 through 1974, I chaired the Department of Epidemiology at the University of Texas System Cancer Center. I have authored or coauthored about 150 publications, most of which deal wi"^h different phases of cancer epidemiology, and I remain actively involved in a number of ongoing research studies in epidemic'ogy. I an also the editor of the Epidemiology, Statistics and Cancer Control section of the Yearbook of Cancer. I share the concerns of this Committee regarding cancer morbidi`y and mortality, and Z encourage legitimate efforts to control this disease. However, as a scientist who has dedicated her professional career to a careful study of cancer epidemi- ology, I an appalled at the belief implicit in H.R. •495?, H.R. 5653, and S. 1929 that Congress can legislate scientific _-_:. _* urge this augu<_ -.c1-d putting itself in These bills a. :::d purpose because of of lung cancer. .->>es of lung cancer < --=::er science or gover- - o-4 identifying the r causation that H ='P-e, the depth of -_zing the effects -'s;.rv and environmen One of the r• ='_::dings regard of the prim --rents are based, i. _as ,,,,nducted iarc -'ryAG =:ze data of - s -:cre aware the = an most laymer -.~ncress must u. -, and no amount -••=^ animals d

=aftr J. Macdona2a -s of tpidenioloqy :aact= Prev.ntioa Systea Canc.r Center .aor Znststute. 1/oMstaya*-@4"* 1cdonald, Profs uor tw.!lts4 it :f Texas System Canc.r dMa%wt;_ :r Institute, youston. I Me+a .oqy for over 40 years ta tait" Connecticut ar.d Texasr sa :a". aacer registry in the i:. f. tivo e Department of Epid.eso.>qy at 'ancer Center. I have autnarsd ct )ns, most of which d.a: v:tL emiology, and i :ema:n research studies in ep:d.msc:oq;. demioicgy, Statist:cs and Cancrt ^f Cancer. f this Committee regardinq canCK encourage legitimate efforts t* as a scientist who has ded:cat.d reful study of cancer epideai- !lief implicit in H.Q."i95'. gress can legislate scientif-c 569 _a augus*_ body of we1'_-intentio.^.ed lec'_s_ators to =aelf in such an untenable ncsition. •se bills are a misdirection of governmental energy ruse of their narrow focus on smoking as t`e ma;or .ancer. We do not, in fact, know the cause or cancer and it is not in the best interest of or government to take a simplistic apprcach to the .__-7ing them. There are obviously many factors in that we have not yet begun to understand. For o*_h of our uncertainty is still far _co great _ffects of nutrition, work history, sty:e, ... _. cnment. = the main reasons that I disagree :ri _ n tzese regarding smoking and cancer stems fr_m my ^e primary type of evidence on whic: these :ased, i.e., epidemiolegical. As an epide=ic'-cgist ._-ed large-scale oopulaticn studies, and w=o ^as ata of vast numbers of researc:^, reocr_s, : a.:. :•.+are than many scientists -- and certa'_n:-, more :t _ay:~en -- of the limitations of .,.._s =:ce of ::.ius_ understand that epidemiology l .s n..c an exact a:^ount of wishing can make it so. We ca.. nct t.._.. .r._.ma1s di_ected at will toward various = -csur=_s. (2)

570 We cannot send all death certificates to one infallible pathologist for correction and confirmation. We cannot force all individuals supplying the raw data to epidemiologists, or even all epidemiologists themselves, to demand the type of precision necessary in data gathering and review to ir.sure that the cuali*_y of the data meets high scientific standards. Consequent':y, iudgments about chronic disease causation based on epidemiological findings must be highly tentative; they do not enjoy the absolute certainty implied in the findings of these three bills. :^crtality data are frequently used by eoidemiologists to study disease trends, often wit!:cut _°u'_1 awareness of inherent weaknesses in these data. :?ortal'-tl rates are cbtained from information on death certificates furnis'r.id by physicians or local health officials. Although I am certain that every effort is generally made to fill these out conscientiousi_, errors do occur -- in diagnosis as well as in recording of the data. In addition, other excgenous influences can cause pro- found fluctuations in mortality data over the years that can easily be misinterpreted as changing disease trends. For example, the introductions of each of the seven revisioiis of the International Lists of Diseases and Causes of Death (ICD) have had effects, generall_v improvements, on the classification of (3) __seases. :Bi_: each _e _isease trends has --een -.,rted. Sadly enough, = ain the classificati: _-oerfect. The possibili_ _zout a rise or fall ~- __..estigators question :_atis*_ics on causes of _=ace _^e patterns of ; -.•.:s t =emer.wer that the : _..=_.,iuced a classi'icat =:.~m metastatic cancer _..scecified as to orima ._s a sharp reduction i: --._ _ :en a rise in both -:::c d'_d it take for th =--..rately did physicia -oondar•f? When epidem_ -ncer trends, do they -_cor.darv cancers? We c -estions. ~ o77, t)----37

571 .s to one -..fallib'_e __ion. we cannot force all epidemiologists, or even and tie type of precision to insure that the cuali`y andards. Consecuent_i, _usation based on _1 tentative; they do not _n the findings of these ! used by eoidemiologists full awareness of inherent _ates are obtained fren iish=d by physicians or certain that every effort :nscientiously, errors co ording of the data. ?n_°'-uences can cause oro- :)ver the years that can disease trends. For :he seven revisions of the uses of Death (ICD) have n the classification of ..'_seases. ,vi_-" each __vis'_cn, however, _.__ _..~_ t: z disease trends has been bro;cen and in sc:^e ..3ses serious_v dis- torted. Sad'_v enough, even thcuch -_ has taken us centuries to attain the classificatior, system that we now have, _t is still i:^Derfect. '°he possibil_t7 of shiiting classi°ications ..ringing about a rise or fall in certain causes of death makes scme '_nvestigators question the value of any effort to compi'_e statistics on causes of death. For esanple, anycne atter..pting to trace _:e patterns of lung cancer during ,.he t_we.^.tieth cen tury must renember that the 1948 ICD revision, '_rst applied _.. 1949, _..z-ccuced a classi'ication secarat'_ng riTar7 cancer of the lung from metastatic cancer of _^e lung (ccded _hereafter as "~nsceci='_ed as to prinary or secondar_v). For t:oo ,ears, there was a s'r,arp reduction in the repcrted primary _,.nc cancer rate, and then a rise in bcth the p i:-ary and unspec'_'ied rates. 3ow lonc d'_d it take for the new classification to catch on? iow accurate'_p dia :hvsicians distinguish between ,-_:nary and secondar. ? svhen epidemiolcgists study z:went__.... __..tur_ '_,.-g cancer :_ends, do t:^.ev include or eSciude the unsneci_ied and secor.darv cancers? t.e cannot be sure about the answers t., _: ese cuestions. (4) -u77 o-s2-.,,

572 The 1965 ICD revision, acco*_ed in 1968, seriousl compl'_cated the situation by deleting the unspecified catego r. This revision effectively combined primary and unspecified lung cancer, thereby removing a needed safeguard for accuracy. Primary and secondary lung cancer are separate disease entities, with quite possibl_v distinctly different causes. Since ten ger- cent of all cancers spread to the lung, and since, for nearlv twenty years, more deaths were coded in the unspecified than in the primary category, the combination of those two categories seriously confused the lung cancer data. The damage done to epidemiological investigations of lung cancer by the 1965 classi- '_ication chanae cannot be underestimated. In the ninth revision (i980), greater confusion was added by placing the bronchus and _ung unspecified as the ninth subdivision of ari:iary lung ca ncer (162.9). Death certificates seldcm list more than a three-diait number, such as 162. t1e simply cannot separate cut °rom the mortali ty data the specific information we need to study '_una cancer scientificallv. Another aspect of the problem of changing disease classifications can be found b_v comparing trends in stomac^h and lung cancer. In the first half of this century, the phrase "question of gastric cancer" was used .._eauentl_i on death certi- ficates when a cachectic oatient died within davs or hours of first summoning a?hysician. It is fascinating to see that in states, within the repor 3ud.:enly as the uns .::anges may in par` from the difficult _'f:cult to diagnc Besides :^erail lung cance _,:crted lung canc -,_ years, those : cancer focus• - _.ers:iv tended t -.c wever, more att. __cluse of report-- _i ~ that increaE: this inter -=ser•raticns abcu zonclusions d- ?irst c ccking prevalenc =sZ _..formation yet the

573 _.. 1363, seriousl;~ the ..nsaeci:ied category. _mary and unsneci=ied lung afeguard for accuracy. seoarate disease entities, .nt causes. Since ten per- :g, and since, for nearly ia the unspecified than in : of those two categories ata. The damage done to : cancer bv the 1965 classi- ::ed. in the ninth revision v placing the bronchus and sion of primary lung cancer ist more than a three-digit :ot separate out from the '_on we need to study lung olem of changing disease 3ring trends in stomach and this century, the phrase : frequently on death certi- d within days or hours of fascinatir.g to see that in 47 states, wi_aiz two years of the ir.troduction of the 1348 _evision, the reported gastric cancer mort.ai:`_ rates dreo_'.ed as suddenl_v as the unspecified lung cancer ones rose. Thus, the two changes may in part represent a shift of cuestionable diagnosis from the difficult to diagnose stomach cancer to the ecually difficult to diagnose lung cancer classl=lcat:on. Besides studying anomalies that have developed in overall lung cancer trends, I have also examined trends in the reported lung cancer mortality rates for women in this century. ?or years, t:ose individuals who believed that smoking caused _ung cancer `ocused almost solely cn male lung cancer, and generaliy tended to ignore female lung cancer. Irn recent years, however, more attention has been given to female lung cancer because of reoorts of an increase in female lu.^.g cancer and the claim that increased cigarette smoking was responsibie. I do not ;ccea* this internretation because I have serious sc'_entific reservaticns abcut both the accurscy of the underlving data and the conclusions drawn frcm it. First of all, we simply do not have reliable data on smokina oreva:ence in women -- or in men, for that matter. The best information we have is from the National Health Survey =eccrts, yet the 1979 reoort, for exampie, has a standard error (6)

574 of 30 percent. That percentage of error is too high to prcvi4-e a basis for drawina definitive conclusions. Secondly, I have doubts about whether lung cancer in women has actually increased dramatically. As I indicated earlier, national mortality data may not be reliable. _f we assume for the sake of argument, however, that they are _eiiable, We can still question the argument that female lung cancer has increased sharply in recent years. Although the age-ad'_usted J.S. death rates from respiratory cancer in white females show a consistent increase from 1953 through 1975, the rate of t::is increase has varied over this period. A smoothed year-to-year variation in the rate of increase -- the slope -- indicates that a sharp rise began around 1960, but leveled off around 1970. Althougn the rate of increase has begun to rise again, it is not as steep an ascent as in the 1960's. This is important because the slope gives a predictive picture of the overall mortality trend. And the slope that I see for female lung cancer suggests a stabilization. It :-iay even nredict a decline in lunc cancer mcrtalitv in the coming years. Other factors must also be considered in an anal.rsis of the apparent increase in female lung cancer. One such =actor, inaccurate repor`ina, appears _o have played apredominant _.,__. (7) analvsis of b z:~-ests that lu: _s being ove= Jnderr( =..r=_e clinical 4.. -_ncer, 2) inade .-acnosis of lur __saases. First _eve that wcr. _..c_ , and thac =_ond, phvsicia -,cause thev sir. -._ resence of -._se li:litation _..~_ resoirator ~:ey may had lung

'. error is too high to prcvide a _•lsions. about whether lung cancer in :matically. As I indicated mav not be reliable. If we .cwever, that they are reliable, t that female lung cancer has ,. Although the age-adjusted cancer in white females show a :ough 1975, the rate of this iod. A smoothed vear-to-vear -- the slcoe -- indicates that :ut leveled of= around 1970. begun to rise again, it is not s. e the slope gives a predictive rend. And the slope that I see stabilization. It mav even ~rtalitp in the coming years. ce considered in an analysis of :r.g cancer. Cne such factor, ave played a predominant role. 575 xy analysis of both reporting techniques and _.._ r.cer:_~i~c d_• _a suggests that lung cancer in women was underrepor_ed _.. _.._ ~as= and is being overreported now. Underreporting may have occurred pri^:ari'_: because of three c'_inical factors: 1) less ciinicai interest _.n female :ung cancer, 2) inadequate diagnostic tools, and 3) clinicai mis- iacnosis of lung cancer as tuberculosis or other _espiratory diseases. First of all, for many years, clinicians tended believe that women were less likely than men to develcp luaa cancer, and that belief could have affected their diaar.eses. Second, physicians were less capable of detecting lung cancer, because they simply did not have adequate means c= d>scoveri::c the presence of a cancer. Third, mainly as a consequence e' _i:ese limitations, physicians may have confused lung cancer wioh ct:er resniratory diseases, particu'_ar'_v tuberculos'_s. 7._ ot:zer words, t`.:e,7 may have diagnosed tuberculosis N:en in fact t~ie catient had lung cancer. The introduction of antibiotics and other drugs led _c a shar= decline in deaths from tuberculosis and other _..'ect'_eus diseases. With isoniazide and these other drugs at their dis- gosal, physicians could suddenly separate the luna cancer tat'_ents from the tuberculosis patients, because r's.e T3 patients .anerall. i:aproved after drug therapy whereas _:e cancer patier.ts (8)

576 did not. The abrupt drop in tuberculosis rates _f___ the zntrcduction of isoniazide in 1952, and t:ze nea- simultaneous increase in reported lung cancer rates, provide substantial suppcrt for my belief that these diseases were o:ten confused clinicallv. Therefore, as these druas became _ncreasing'_y available, underreporting of female lung cancer became less common. IInfortunate'_y, there is evidence which suggests that today lung cancer in women is overreported. This may occur in one of two wavs: (1) clinicians are not always able to dis- tinguish between primary and secondary lung cancer. As discussed earlier, the distinction is of obvious '_mportance for a factual cour.t of pr'_marv lung cancer cases. T.`.e, only truly effective way to determine whether lunc cancer is orimarv or secor.darv is through autopsv, and few cases of cancer deaths in this countr,l are autopsied. In general, the autoosy rate is about 12 percent. When one considers that this percentage includes all the accidental and viclent deaths that must be autopsied, or.e understands ]IIst how 1Cw the autCpsV rate f.._ lung cancer may be. This issue becomes even more crucial because pr'_-:ary lung cancer is one of the more difficult diacnoses to establish ci'_nicallv. (2) The current ICD classification combines primar^'•and unspecified lung cancer into one category. Even i'_ the cl_n'_c'_an could cerrectl_v distinguish primary from unspecif_ed lung cancer, (9) z:e effort would be . hcth orinarv and unsr reports that have des, Therefore, c _n disease nomenclatur the epidemiologists' : reoorted trends in 1ur. =rue incidence of the Further sup __..___'_cat'-on of ciga =_..cer stems from my c :~re, a study of 1'. .c,.en in El Paso, we f =%anish surnamed, 64 r --me percentage of tht cancer was half t '-.a= we had to rule - ---s _aad , t he most i MF -,en's lung cancer wa adobe houses. Tyee =---_ ventilated stru S-d the women to ;c

577 .csis mcrtall=•/ rates a=ter and near'_y cancer rates, prov:de = these diseases were often these drucs became _ of 'ema'_e lung cancer 3ence which succesus that orted. This may occur in ^ot always able to dis- lung cancer. As discussed imoortance for a -factual ..ey on1_, truly e:=ect'_ve way imary or secondary is :er deaths in this coun*_ry ~ rate is about 12 percent. :age includes all the ;ust be aL`toDslea, ore ate :cr lung cancer aav be. ecause primary lung cancer 3 to establish ci'_nicall_v. combines primar•."• and )r.),. Even if the cii.^.'_cian :m unspeci:ied lung cancer, t:e effort would be negated by classification met`.cds. Thus, both prinary and unspeciiied lung cancers are combined a .n the reports that have described increases in lung cancer in women. Therefore, changes '_n diagnostic techniques and chances iz disease ncmenclature are very important because, speaking from the epidemiologists' point of view, we cannct be sure that the reported trends in lung cancer among women accurately reflect the true incidence or the disease. Further support for my skepticism regarding an _denti`ication of cigarette smoking as the primary cause of lung cancer stems from my own research _nvestigations of this disease. _•n one, a study of lung cancer in Saanish surnamed and Anglo women in El Paso, we =ound a high incidence of the disease in the Spanish surnamed, 64 percent of whom were smokers. Although the same percentage of the Anclo women also smoked, their rate of lung cancer was half that of the Spanish surnamed. tve concluded that we had to rule out smoking as tae significant factor. lnstead, the most important factor i.^n the Spanish surnamed women's lung cancer was their residence from birth to adul=:ced in adobe houses. These are solidly built, nearly airtight and poorly ventilated structures heated mostly by wood tires, which exposed the women tc known carcinogens.

578 In a much larger study, mv colleagues and I_:amined the relationshio of environmental and ethnic factors to cancer mortality by site for every state and region of the U. S. for a twenty year period. We began with a very large number of vari- abies or factors, from which we selected 12, among them c'-garette consumption, intake of different kinds of alcoholic beverages, ethnic background, oollution, income, temperature, etc. We used these to derive sophisticated statistical models of the geo- graphic patterns of cancer mortality in the U. S. These models were an attempt to describe b_v statistical ecuaticns the relationships between certain factors and cancer mortality. Gie found that all the factcrs used in the study accounted for only 36 percent of the geographic variation ir, white female death rates from cancer of the bronchus and lunc speci;ied as primary. °he best model -- which eliminated the unimportant factors and brought into focus the important ones -- accounted for 29 percent. (In contrast, the models accounted for 89.5 percent of the variation in cancer of the breast.) This indicates that unknown but crucial =actors were not included in the variable cool from which the model =or primary lung cancer was derived. Cigaret*_e consumption, which was included, turned out not to be a factor. We also disc inarv lung cancer _- -- 'or both white fer ..ecause it shows we cE ?resent a factual pict There are ot .a'_anced discussion of _. '_ncreasing numbers __.__- have traditional: °-^aerlv reserved for =_-_^un'_tv and work en _.. -.-„wn carcinogenic c, The tremendc _rtorne chemicals orcc ou tdoor anvironme:: -';esc a set of facto ay. In 1976, I _ ~cssib'_e influence .c•,:ston upon lung c_- <--_atorv diseases. facili=ies, mort: _:.seases were fcL -aa_is =rom respi=

579 colleagues and I examined d ethnic _°act.,rs to cancer 1 region of the U. S. =or a •:ery large number of vari- ;ted 12, amonc them cigarette .ds of alcoholic beverages, , temperature, etc. Ne used 3tical models of the gec- in the U. S. These models atistical ecuaticns the 3 and cancer mortality. aors used in the studv .e gecgraphic variation in - of the bronchus and lunc el -- which eliminated the focus the important ones -- ast, the mode_s accounted for ncer of the breast. ) This 'actors were not included in iei for primary lung cancer , which was included, turned We also discovered a•aarn'_ng in the basic data dividing __imarv lung cancer from the unspeci'ied category of 1•sne cancer -- for both white females and white males. This is imoortant because it shows we can't be sure lung cancer rates, as reported, resent a factual oicture. There are other important considerations _ cuired in a balanced discussion of lung cancer in women. For instance, women iz increasing numbers have, over the last 35 years, :eft the jobs _:ey have traditionally performed and have entered wcr% areas 'orierlv reserved for men. Wome.^n are now esxsed to _=:e same commun'_ty and work environments as men, and there are many .n:cncwn carcinogenic potentials i.^n these env'-ronments. The tremendous varietv of toxic and carcinccenic airborne chemicals preduced by industry and released into _.^.docr and outdoor environments, in our homes and our '_aces, suggest a set of factors which may be .^tertant _.. '.ur.g cancer etiology. In 1976, 1 published a 30 year study which examined :e oossib'_e _z'luence of the oetro-chemica'_ _ndustr•• e:aosures in :custon upon lung cancer mortality, heart diseases, and ct:er _esniratorv diseases. In certain areas clustered around _ndus- __ial ?acilities, mortai?ty rates °rom respiratory cancer and .,taer diseases were found to be ver high -- so ..igh, _.. fact, =`ac dea=hs °rcr: _=scirator•i diseases near'_;• doubled over the

580 last 15 year period. Outside the industrial "pathway," morta!ity rates had remained stable for twenty years. A similar _indina was made by Clemmesen in an industrial city in Denmark. These epidemioloa_ical findings are strongly suggestive of the fact that industrial exposure factors underlie the etiology of lung cancer. I might add that I saw no evidence that cigarette smoking could explain the peculiar disease patterns I found in Houston. Our increasing ability to identify industrial carcino- gens has opened many avenues of study and emphasized the _.^..portance of industrial environments. Control of these carcino- gens at their source offers the most positive potential for prevention of lung cancer. To date, epidemiological studies of lung cancer have not generally included adequate in'or:nation about occupationai exposures. Frequently, an epidemiologist may get little more than a brief indication of occupation -- such as, "construction worker." This tells us nothing about that person's actual exposure. At the M. D. lndersor., cne of the major centers in the U. S. for the study and treatment of cancer, records are ever. less informative: the vast majority of cancer patients' reccrds simply list "retired" as the occupation. How helpful, then, can we expect the reccrds of private practitioners and community hosoitals to be? Even when attempts are made to elicit fu'_1 __.::rational expcsure his -.emory of previous expos _^conplete. I seriously .as an exact record of tY :-.ounts, to which he may i :ariod. And his wife, wh •r_usewife, would undoubtec -.._ cleaned from his work Still other imp _.._ aentioned, are emer ,..c__ causation. Scient roles played by _ __ncer. Although this :_':usions do not aooear ._-~a ..= research does poi ___...,c unknowns in t^=_ ,rom mv own stuc _esearch recorted :- _=nt that calling c'_ factor in femal r comolex eoidemic

581 stria: "pathway," :^ortality years. A simi 1ar _indir.g 1 citv in Denmark. These suggestive of the fact that he etiology of lung cancer. at cigarette smoking cou'_d - found in Houston. :entifv industrial carcino- .dy and emphasized the Control of these carcino- positive potential for .idies of lung cancer have :nation about occupational gist may get little more -- such as, "construction it that person's actual of the major centers in the cancer, records are even ~f cancer oatients' records :)n. How helpful, then, can :ctitioners and communitv are made to elicit full occupationai expcsure history, the patient's ancwledge and/cr memory of previous exposure will undoubtedly be faulty and incomplete. I seriously doubt if the typical industrial worker has an exact record of the hazardous substances, much less the amounts, to which he may have been exposed over a 30-40 year time ?eriod. And his wife, who mav well describe her occupation as housewife, would undoubtedly know even less about the substances she cleaned from his work clothes all those years. Still other important areas of research, besides the above mentioned, are emerging in our study of the puzzle of cancer causation. Scientists are beginning to recognize the pcssibie roles played by nutritional imbalances in the et•:oloay of cancer. ?'_thcuQh this ..iscioiine is still in its infanc•i and conclusions do not appear to be immediately forthcoming, this new area of research does point to _he fact that there exist many scientific unknowns in the study of cancer causation. From mv own studies and from a considerable amount of .,:her researca , morted in the "_*_e-ature, _,t is _:^.ere=cre pparent that calling cigarette smoking the sincle na;or causative factor in female lung cancer is an oversimplification .,f a ver_v complex epidemiological problem.

582 Ccnc'_usicn There is a concept widely accegted by publiz: :eal=: schools that if many studies, in themselves not based or. definable nooulations, all arrive at the same _onclusion, _:en that conclusion must be valid. This concept disregards the 'act that the same intrinsic error in method might produce the same result. ~a the first and subsecuent Surceon General 's repcrts, one of the main sets of supDortlve data was based on tC:e surVeV of L.'le American Cancer JecietV. The lnadecuac7 of t.._s sL•=veV recoc.^._Zed and cr~t_ca.iv anal'7Zed bV Tla nv o~ t..,. ~ore^cst was szatistic?ans and epiden'_o:ccis_s at ..i:e time, including 3ir Ronald cisher, the 'a_:er of statistical methods as we ncw _ ractice *_hen, Dr. Joe Ber!cson of the Kavo C'_i n_ ,who devisec the .^..ethcd o_- reDOrtlng su_^:ivals we ai_ use, ?rofessCr K. A. $rcw.^.'_eer for the ?Iaer_can J'tatls.._CCai Association, Dr. DO nald Mainland, ph.sician and teacher of medical statistics, a...: numbers of ct: ers. In the Cancer Society study, thousands of women y cuesticns' about rolunteers asked of their acquaintances man, tr eir tersor.a'_ habits. 'Io one cuestions ...`.e si::ceritv o` _.._ women, but no business would consider ____nc its sales golicy on (: )

582 __.:sion widely accepted bv publi_- , in themselves nc*_ based on .ive at the same conclusion, _ :en This concept disregards t :e 'act iz method might produce the same :secuent Surgeon General's reports, -tive data was based on the survey The inadecuacv of this survey analyzed by many of the `orencst sts at the ti,^e, including of statistical methods as we nCw i of the Mayo C_'inic, who devised ~-als we ali use, 9rofessor R. A. _,.i st'_cai Associa-lon, Dr. Do :a'_d :er ..'_ medical st3_istics, and aty study, thousands of women ;uaintances many cuesticns' about _ cuestions the sincerity of the _onsider basing its sales policv on 583 _..,. results of such a studv. The oroncrt'_on of smokers _..__rviewed bere no resemblance to _he procor_'_on of s...c:cers _.. -..e pepulation, which demcnstrated that the women surveyors Hen_ cut to _ind smokers. Twenty-five states were not :n the study. __ was largely an urban New York, New Jersev pcpulation, c' pcer ...:ddle class people. An enormous literature has grown up on the sub:ect of =...o{inc. But the bulk of the evidence is statistical. _._ nc s_-c:e :nstance has cancer o~ the lung been produced an•:._ean:ng='ll animal experiment us:ng tobacco smoke _._ha_'at'_o n, even _-.,.:cr millions of dollars have oeen sz;ent _n the _==or_. :n a_1 .^.IV Vears as a cancer eCl':emlolCC_st, Z^aSe seen ..._nv tn:eories studied and debated. But Cnlv in the instance of =ne smoking t:eorv has the theorv itself become sacrosanct. A:.•; __ _i:e many vad id scientific observations which _..:..t_ =he t hecr^ __ _..iscounted as bizarre. .%!an y a doctorate on ..uman psycnoloc•: be earned in the future, when the actual cause of '_u::c __._.,ar heccmes known, wnic.- will attemDt to _..,. _..t..nsit_ ' _..e ?romoticn of this unproved -:zecry. Science, by explaining one fracr..ent after another c: .._tic, .,iochemical, somatic, behavicra:, env'_ronmental, and _ nal ~..'crTaticn, ~s building gr-adual:y the structure, (1s) 1 (iti) I

584 cahich, upon co-nleticn, will help us understand __`.e cenesis of cancer. i_ is beceming increasingiy clear that =:e_e is ne si.^g1e, sisplistic answer to the question of what causes respiratory cancer. It is hardly in the best interest of either science cr gcvernment to create the illusion that an attack en a single lifestyle factor will provide the so ution for such a complex problem. The proposed legislation creates this i'lusion and should not be cassed into law. 1. cmba: ^un1 _ :_•~1 '2 ';r 2. J. uG?-i_ . _: ...~ . .. ~C.• . ..a,. :cr. .ssarua?tts. = ~~- - ~-~? -.. 3:Ii1 SGGI -- -' '_..

understand the genesis of clear that there is no iestion of what causes the best interest o: either. .1lusion that an attack on a _ the solution for such a- _ation creates this illusion 585 PUBL.C\T :O :'.; 1. i.cmbard, H. L. and 'lacdr)r•:(•.!, E. .i.. ?'ublic 'r'^alta. Courier o: thc L~~rrnatior.al.~ F•__'ern .,.. .,C ..! :-„•.77,77 -(') ).l'-14, 1131. 2. LomL':irci, El. L. , and !'lacclOnald, C. J.. St -... . Cancer C:inics .is Seen by the Practicing ?hysician. =v:'_zn! " .ocl, "1Oi:(20):9,9-951. 1911. - 3. :.omcard, S. L., and Macdonaid, E. J. : Co~n1et_ res ,:is Control of Cancer. Public Health rsin 1. tac:ionalci, E. J.: Iiistory of the Czncer ..}_sac!•,;:setts. :n Cancer arlc! Other Chronic Discss.s fiuuqi:tcn >tlf:.in Ccicnany , Rivers'-i=. 1')5,). E. .,.. Hi::toricnl Sketches or. for the Pt~ro~r!:~i :Yts D~,o.,rtment o.'~; . i: i; ,•z:cr'.;•-six broa tcast} which was repriater3 in t`e . '"ha :'is•a o` PubLi.. ;:,.a1t): consciou_:._.;s- 1934. E. J.: f(isterical Sketc!:cs c.n . rFpa;.,d for the :•tassachusetts De',ar•mr2^t ! .. ...... ... . .+r.): .c! I,, 11.,. .. ' i.t `i)rl.'-3ia brUarlcasti; which _sn.i J !ei. Edward Jenner, 210:(23):1233-121~9I, ..., - ;. 'ac__n.3i; E. J.. ;!isto• -~3l 5k_,ches n?'_ _- <~1 for the Massachusetts De;,artaent o:.:•~ -_ :!C31ta aad sccnsored by the Mlssac!:usetts Ltedical Soci:t•.•. .r.e of `ort;•-six broadcasts which renrinted in ~nqlanc 'e:. Vaccination of Toda;., 210:(26):13O, 193,. ?. t•!ac:'.~sa1d E. 3.. The !(istorical Trend of iabe-es. Jiabet•_s Vumber, 21: (2) :57-64, 1?.,. 9. ?~~r.onal t E. .7.. f!ist~r:.~l Tror+..lr, in Can..,,.. _c'^ont: _tlth .,=,ncer uu-iber, 21• (~) •.'•37-2G5, 1934. - '_0. :dac.ionaLJ, ,,. J. Chronic i2h„ur.t.ati:•m. Th.= Cc,-r. t_c: ~.dult Hygiene Number, 21:(1):25--'7, 1934. 11. _,:onald, E. J.. Cdoston of 1R00. Tho Ccn. ,a^ .ii ;c.tdio :utab:er, -_. (a) , 1y35. E. J.: Fundamcnt-ils oE Epide:r.io:e-;y. 3adc1:= :r` ~1 19-22, 1136.

586 publications (con' t) -2- Eleanor J. :?ac::o::_-::: 13. Macdonald, E. J.: A History of the Massac-:usct_s Department of Public Health. The Commonhealth, 2: (2;, +3 pages, 1936. 14. Macdonald, E. J.: A tlistoric.ll Trend cf (revia=d). The Commonhealth, Diabetes Number, 24(2), 19:7. Publications (con 27. '•facdona ,Jno !tave :f:id Prov 82-84, 1944. 58. Macdona. Entity for Contro: 1sa- Macdonald, E. J.: Accuracy of the Canc3r Dea!l": Records. P.n J Public Health, 28:(7):918-824, 193d. 29. Kacdona: .iho Have Had Prov h f Health Bulletin, ` e _.~__.. t 16. Macdonald, E. J.: New Activities o of Adu1 Hyr.iene. The Commonheal•`_h, Cancer Number, 30. +lacdonal 25:(1):d-7, 1938. - Needed. Conn Hea1 17. )tacdonald, E. J.: History of the Massaciius~tcs ' 31. Macdonal Cancer ?rogram. -5:(3): The Commonheiith, Cancer Number, for Cancer. Conn 192-202, 1938. 18. :•1acdonald, E. J.: The Evolution of Cancer Contro= in Massachusetts. The Med Woman's J, 45:264-270, 1938. 32. Griswold Connecticut Cancer '`.at Med J ll: (5 19. Macdonald, i. J. : The !iu-3nitarian' Move:cer.t. 33. Macdonal The Comaonheal`h, Radio ;1umS,•er, 26:(3):176-179, 1939. Breast Among Women 20. Macdonald, E. J. and Macdonald, F. A.: Z_va1uat?.:rn of Cancer Control Methodology. %:m J Public Health, 3u:(S,r 34. Macdonal ?atient Delaf. Co ;83-492, 1940. 21. Macdonald, E. J.: Statistical Researc7. C:,naac_i.:l: 35. .'•'acdcnal --Aa' ec] for Canc Division, Women's Field Arm of the American Societ^ of Cancer - er Bulletin, 52(3) 1 Control, Inc., Bu etin No. 1, 1942. , 22. Macdonald, E. J.: The Cancer Situation in Connect::- cut. Conn Health Bulletin, 56:(3), 1942. 36. :,acdonal Survival Picture - J N.-k Med Women's A 23. Macdonald, E. J. : Eight Years' Experience in Cz_ncer in T+enty-One Connecticut Hospitals. Conn State Med 37. '+.acc:onal. Rasults. Am J Roe: 536, 1943. 24. :dacdcnald, E. J.: Improve:.ent in Services ':?er.de.ad Conn 932-835, 39 . llr~- :•tacdonal: , in Connecticut Hospitals to Individuals with Cancer. Health Cu1let:n, 57:(8), 1943. Picture .. ?rcgno5is. 1iu11 A: 25. Macdonald, E. J:: Part Medical Record ;.ibrarians :•lay 29~-2>3 (12) 57 39. t•tacdonal, , : : in Disease Studies. Conn Health Bulletin, . . :e olugv oE 1943. aca_ r,my o: Sc' 26. '•t.uu:lun.7ld, i:. J. : Thu 4laf.,.-wicfc Cancer Ruwr:: 3t=,-s•:r1 40. Clark, R. in Connecticut. The }tedical 'rluman's J, 51:26-29, :5, 19:;. ~= Te:cas ;•1. D. Andc ^nen's J, 1949. 95-077 0-82-98

tistory of the Massac`:uset=s :e Commonhealth, 2: (2i, 43 Iistoricnl Trend - J ~b :abetcs Number, 24;2i, 1937. :uracy of the Cancar Dea':: 3:(7):818-824, 1938. + Activities of the ?a1th, Cancer Number, 3tory of the MassaC:au5,:_-_CS :h, Cancer Number, 2 Evolution of Cancer Cor.tro: i's J, 45:264-270, 1938. a Humanitarian Movement. 26:(3):176-179, 1939. •tacdonald, F. A.: Zva:ua:.i::n .:m J Public Health, 3u: (5; ; atistical Research. C:.nzec-i ~' the American Societ•• of C-nr•c•2r 1942. e Cancer Situation in Con.^.ect:`- (3), 1942. 3ght Years' Experier.ce in Cc_ ncer tals. Conn State Med - 7 (3; : orove:.:ent in Services 3er•cerac ividuals with Cancer. Co.^.: rt Medical Record Librarianz .1ay a Bullctin, 57:(12):29~-23:, .. Slat.-.-wi 3e Cancer Ruco::: nan's J, 51:26-29, 35, 1944. Publications (con't) -3- E1,.!anor ,,. 27. '•tacdonald, E. J. : A Report of Living Inci•: i"!::::Li t•ino !lavc ;l2ci Proved Cancer. Conn Health Bu11.2tin 53: (:; : 82-84, 1941. =8. Macdonald, E. J.: Connecticut :1s a Cocperativ•_: Entity for Control of Cancer. Conn Health Bulletin, 1944. 29. M3cdonald, E. J.: Survival Rates of Ind•iv?duuls i•tho Have Had Proved Cancer in Connecticut-1935-19•l2. :or••^. Health Bulletin, 58:(11):844-848, 1944. 30. Macdonald, E. J.: Expanded Chronic Disease Prc;ra:: Needed. Conn Health Bulletin, 60(8), 1946. 31. u;.cdonald, E. J.: The Meaning of Adjusted 't;:to.: for Cancer. Conn Health Bulletin, 60:279-282, 19;c. 32. Griswold, M. .H., and Macdonald, E. J.: The Connecticut Cancer Record Registry -How it Functions. State Med J 11: (5) :3•)4j347, 1947. - 33. Macdonald, E. J.: The Incidence of Cancer r_.._ 9reast Among Women. Conn Health Bulletin, 61:(7), ;3;7.' 34. Macdonald, E. J.: Chan:Ting Reasons for Cancer Patient Delay. Conn Health Bulletin, 61(4), 1947. 35. "acdenal3, E. J.: The Estimated 5umber of iuais Treate•.: _°or Cancer Needing Nursing Service. Ccnn He.:.it Bulletin, 52(3), 1948. 36. Macdonald, E. J.: The Present Incidence ar:3 Survival Picture in Cancer Among Females in Conr•ec__- :. J Am Med wcnen's Assoc,3:(4):152-162, 1949. 37. :Sacc:onald, E. J. : Criteria for Repcrtin c Results. 4n J Roentgenology and R3diu^:Theracv, 932-835, 1?48. 39. >12c'.onald, C. J.: Tho Pr,~scnt Incidance an,i Survi•:i! Pic*_ure in Cancer and thr~ l'romise of Improved ?rognosis. iiu11 Am Coll Sura, 's3:75-93, 1949. 39. ??acdonald, E. J.. Nalir:nruit Mclinoma in G.:r.r.•:c=icut. noas. Sf~ecia1 Publicatieas C. ,.. .. Iz The a:oicav of :4ela m crk acs~emv ot Sciences, 4:71-81, 19d8. - 40. Clark, R. L., and :•lacdonaid, E. J.: The _ of Texas '•1. D. Anderson Hospital for Cancer Research. Wo:nen's J, 1949. 96--077 0-82-38 

<.~ 588 Publications (con't) -•3- Lieanc= J. :! z~.:: :io:-.:::: 41. ?tacdonald, E. J., and +S.i.rlnn.;ld, +t. C.. ^romisc of Imyrovcd Proynosis Tliron-ii Clinical :?c::_,._ Tr Assoc ot Life insurance Med Diroctors of Am.cr, ..c. _ •i 4 - . 1' 4 . 42. Clark, R. L., and Macdonald, E. J.: B3sic, and Sociological Research in a State Cancer Proqra:-. in Collected Papers of the Pub Health Ca Assoc., 1951. 43. Macdonald, E. J.: Evaluation of Statew'-:e Car.ccr Record Registries. ACTA 9:(2):341-343, 1953. 44. Macdonald, E. J.: You Can Help Fight Cancer. Ta::as outlook, 37:(10):10-11,44, 1953. 45. Clark, R. L., and Macdonald, E. J.: The ;:aturai History .f Melanoma in Man. In Pi ment Cell ,rowth, Acada^.ic Press, Inc., New York, New York, - 4, . 46. 'rtall, J. A., Fletcher, 1. A., and Macdonald, S. J.. =_ndometrisl Biopsies as a Standard Diagnostic Tech.^.i:,uo, ;, Review of 445 Cases. Am J Roent-enol, Radium Theranv an:a Nuclear Medicine, 71: - , - 5. 47. Macdonald, E. J.: Eoisemi•ology ci Cancor. ~xas Ret:ort or. Biology and +tedicine, 13:(41:826-839, 1955. 48. Macdonald, E. J. Historical Trends in Cancer. : Cancer, A:+.anual for Practitioners. Third Edition, a.-:cricsr. Cancer Society, Inc. (Massachusetts Division), 1-9, 1956. 49. Macdonald, E. J.: Handbook for Cancer Recisc_:l~s and Fo11ow-uD Services. Printed by the Texas Deoar_r.e::t c~. iiea th and :4. C. Anderson Hospital and distributez Sy the american College of Surgeons to all aaproved tumor c;ir.ics, 27 pages, 1956. 50. Macdonald, E. J.: Natural History of Prosz:ut'_c Cancer. In Third National Cancer Conference Proceedi^cs. J. B. Lippincott Co., Phi a e p ia, Pa., 179- 9, )-,0. 51. Macdonald, E. J.: Section Editor, Epide:r'-oloc_i Chapter, Year Book of Cancer, Year Book Medical Publis:;ers, Inc., Chicago, I inois, 1956-1957 series, 381-391, 1957. 52. Macdonald, E. J.: Methods of Reporting Ead izes::_ts of Cancer Treatment. In Treatment of Cancer and Allic--' Diseases. Edited by George T. Pac , M.D., and Irvi:iq M. D., and Paul 3. Hoeber. Inc.. 573-577. 195B. ?uo lic. ~ _ar.er Ark :ter S' 5 i:._ ..., cacem_ ~ :a^cer . .l-. 0 =hapte: Inc., _ 5 reata• 559-57, 5. ='yapte: .nc., . 5 ~•:aluo°ac:ol.

icdona ld , M . C . : ::: _ )n•-ii Clinical ,~ctors of 1,me-, iald, E. 3.. Gasic, C1:•._::ai ite Cancer Pro~7ra:-. t .a:is :e.i ilth Ca Assoc., 1951. iation of Statewide Car•cer _-343, 1953. in Help Fight Cancer. T.::;as iald, E. J.: The i:atural _ ment Cell Growth, Acade^•ie _ - . 9 . H., and Macdonald, S. J.. Diagnostic Techa`;ua, ;, .no1, P.adium Theraov and -i-a1 Trends in Cancer. :n _ rican Third Edition, a. s Division), 1-9, 1956. :ook for Cancer Racistr:^-S ,y the Texas Deoar =e::t c- and distributed Sy the 1 annroved tumor clir•ics, -a1 Eiistory of Prostatic Conference Proceedi.^•cs. t, Pa., 179- 9, 1956. .on Editor, Epidemiolocy - Book Medical Pubiishcr5, series, 381-391, 1957. •ds of Reporting End Res::l-_:; : of Cancer and A11ie'_' M.D., an 73-577, 1958. Publicat'_ons (con't) -5- ::iea::or ... 53. M3c:ionald, E. J.: Section Lditor, Epid~r.: _lc C::aoter, ~ar uuck of Canc+!r, Year 13oc: t.icdicai Inc., C!:i.,a4o, . 1inois, 1957-19.3 scries, 435-431, 1:5.• 54. i?3r-F11, W. 3., and M,lcrjonald, E. J.: Ccr;: .:: Car.;_er in a Si^al1 County Medical Society Tumor Clinic. J Ark Med Scc, 55:(3):109-112, 1958. 55. Macdonald, E. J.: The Epidemiology of Skin Ca« cr. J invest Derm, 32:(2):379-382, 1959. 56. '?.;c:icnald, E. J.• Mali.a_nant Meianoma ;L.,•.;:;; an~- i-tin ..:.•aricsns in Texas. In Fi.rn,2nt Call Acacemic Press, Inc., New York, New •[orr., - , iD. 57• 'a:accior-ald, E. J.: Section ii3itor, Epi::c:niclo.r CF•apter, 3~ok of Cancer, Year 3ook Medical P:.biis:+ s, Inc.,. Chica •c, . rnois, 1=3-1959 series, 467-ti8i, 58. ~'acdenlld, E. J.:- Occurrence of Multic•le Cancer in a'opulation of 200,000, '-944-1955, Ar"; 171.2-1710, 1953. i9. "acdunald, S. J. : A R.2nort of :lichita Count ~ t•_ic:!icai ~ccictv Tumor Clinic and Fo iow-t1o Pro,;ram, The Cni•::rsiyo of Texas M. D. anderscn llospital and ':umcr Institute, 1960. 60. ,Iacdo^.ald, E. J.: Section Editor, Epide^iolc,y Chapter, Year L:ok of Cancer, Year Book Medical Pubi at~rs,_ Inc., Chicago, il inois, 1959-1960 series, 401-416, 196u. 61. Ross, S. W., Macdonald, E. J., Davis, P., i•iar.-,arstan, J., and Levin, W. C.: A Method for Evaluation of Disease and Treat••nent in Chronic Leukemia. J Lab and Clin Med, 58: (4,: 559-579, 1961. 62. Macdonald, E. J.: Section Editor, 'cpidemiclo?.; Chapter, Year 3ook of Cancer, Year Book Medical Pubiisnars, Inc., Chicsgo, I ino a, 1960-1961 series, 421-432, 1961. 63. ,!acdonald, E. J.: Method of Analysis for Evaluation of Treatment in Cancer of the Oropharynx. Radiolc?1•, 78:i5):783-789, 1962. 64. Sa:nue13, :d. L., Howe, C. D., and Macdonald, E. ... • A1k;•lati,ig •+-,•ents in the Treatment of Patients with .d:ar,cc' Cancer of :varv. In Carcinoma of the Uterine Cerc'_x. -_:o- Tutri.tm a,ni Gv,lr •. Ycar Book !•(uc icai Publishcrs, Inc., ;:hicago, :1linois, 329-338, 1962. I

4! • 590 Publications (con't) -6- Zleanor .; . :tacdon::i_' 65. Macdonald, E. J.: Section Editor, Epide^ioleq;• Chapter, Year Book of Cancer, Year Book Pteciical Publia`.crs, Inc., Chicago, Illinois, 1961-1962 series, 411-424, 1562. 66. Shullenberger, C. C., and Macdonald, E. J.: Evaluation of the Comparative Effectivenss of Myleran and 6-MP in the Management of Patients with Chronic Styelocltic Leukemia. Ca Chemo Reports, No. 16, 203-207, 1962. 67. Sprague, C. C., and Macdonald, E. J.: Evaluation of the Effectiveness of Radioactive Phosphcrus and Ch1or.:nbu_-:1 in Patients with Chronic Lymphocytic Leukemia. Ca Che^.o Reports, No. 16, 235-240, 1962. 68. Macdonald, E. J.: The Epidemiology of ?!ei::no^a. In The Piament Cell, Molecular, Bicloaical, and Clinical ;_. Asoects. Annuals o the New York Academv o Scienc=s, ...0 4- , 1963. 69. Clark, R. L., and Macdonald, E. J.: .lnallsis ..: Results of Trestment of 40,000 Consecutive Patier.ts at a University Cancer Hospital. Acta Unio Internationali3 Con-=: Ca.^.crum, 19:(6-7):1479-1494, 1963. ~ 70. uacdonaid, E. J.: A Renort of the El Paso :!e3ical Societv Follow-up Progra:n, 1944- 96 Texas _...._~_ Cccrdina:ing Councll. The University or Texas ML D. :.:_z!-3:... Hospital and Tumor Institute, 242 pages, 1963. 71. Macdonald, J.: A Report " the Cancer Rac:iz-__ of Johr. Sealv ilosoital, + alveston, Texas, 194d-1960. Univers:tj of Texas M. D. Anderson hospital and Tunor 72 pages, 1963. 72. Macdonald, E. J.: A Renort of the Cancer 3ez'_s_ry c: the Parkland Hospita_l, Dallas, Texas 1946-1960. The OL Texas .f. D. An erson Hospita an Tumor Institute, 69 ;;_ges, 1963. 73. b+.ac.lonald, E. J. . A Rc .ort of the Cancer of the Jef:erson Davis Hosoita ltouston, Texas, The Unzversi ty of Texas M. D. Anderson Hospital anci ..::.cr Institute, 32 pages, 1963. 74. »acdonald, E. J.: A Descri:tion oE the Cancer ;'ro-ran of the Roccrt B. Green Hospita, San 7ntonio, Teaas, .erson aospltai anci .:zor The UnLVersit, o- Texas M. 0. Institute, 36 nages, 1963. 75. '°acdona:d, E. J. : Re~ort of t:ie Cancer Laboru'or1 0' Drs. itart, Covcr>.c. [~Iack, CI5 n, r_ an t6hit o` Cir ~1 paso Count-: }tcciicil Socie*_~Fo i.--_ Ot Ccxas Frogcam_ Hos:itau a^u Tumor Institut_, 34 naaes, 1963. M Pub1i_ations (con'tt 75. ..: .._r.a1 r :he C1: ot Urs .uical ao•_1et•: Folic exa 3 MAnders 1963. 77. '•tacdonald , t!:c Southwestern Gene Societ: r'ollo*w-L',) Pro :•;. D. Anderson Hospit 78. t•+.acclcnald, o= the 71 P3so Countt 1?61. Tha University Tumcr Inwtitute, 34 p 79. '•?acdonald, arzl :!osoital oE t eroc:ra:*, 1944-1961 .!o5oltai .1r.•: .,:mor .n i") . }+,cdonald, =:1d " lEr abQ'ator - ±[.]^t, iy :.nilerscn :oSJitai and _ - ''-t,:o Tumor Cli ow-U ?ro:ran, er<-on :::.s;:i-'tal and 82. :•lacdona ld , the Providence Memori Society Follow-Up Pro M. D. Ar.aerson Yospit 83. Macdonald, Chapter, Year Book of inc., C::icaa-,o, IbTino 84. Rose R. G., Macdonald, E. J.:' Th Prior Irradiation in 4:249-258, 1963. 35. Macdonald, S^:i*_ti, L., Garrett, !i 1ar.is aqain5t Skin Ca Invest Derm 41:213

Lleanor J. ::accon l~ on Editor, Epide^iolcg;• [look Medical series, 411-424, 1962. :d Macdonald, E. J.: ~ctivenss of Myleran and ; with Chronic Hyelocjtic .6, 203-207, 1962. lonald, E. J.: ~valuatioa ie Phosphorus and Chloraabuc:'- =ic Leukemia. Ca Che^.o :pidemioloqv of S+.el:.r.oms. icloaical, and C1in'_ca1 Aca emv o Sciences, ,C~) -ialc°., E. J.: Anallsis c: isecutive Patients at a Unio Internationalis C oort of the El Paso ^ou-= ti4- 61. Texas Ca..-Q= slty~or Texas M. D. pages, 1963. oort of the Cancer R:c:s::__ Texas, 194a-1960. ° n Hospital and Tumor oort of the Cancer Rez'-s_r-Y c: xas 94 -1960. The an Tumor Institute, 69 p_ges, ~ort of the Cancer ae?'__c _: •;• ilouston, Texas, 19 .erson Hospital and •:u-cr scription of the c:ar.cor ''r:'-ra-1 5an 1lntonio, Texas, .erson Hospltai and Tuzior 'rt of thr. Cancer .c,;'_s- :ric, tslack, CIa fF, n, _ nages, 1953. 591 Publi:i_ions -7- Ei,:~ aco: 75. 'ac..nalci, .r•.. J.. Recor •)E - Cnac.. - •-- .• _ _? thc i;l oE Urs. Smith anu rrcic t^e ~ Soci Follcw-Uc Program, c° .exas .,. D. AndersoHospital and Tumor Inst:tu~,.!, 1963. 77. Macdonald, E. J.: Reccrt of the Cancer 3. ' c the Southwestern General Hosoitai of the E1 Paso COur.t•• Societ: "r'oliow-i:c Program, 194•1-1'6i. The Universr`: cE M. D. An3erson iospita an Tumor Institute, 34 payes, _)i3. 78. btacd^nald, E. J.: Reoort of the Hotel o' *_he =1 P3so Cour.tv Medical Sociatv Foilow-'jo ' 1,'61. i !:Q University or Texas M. D. An erson Hos:)it:,: Tumor Inwtitute, 34 pages, 1963. '9. !•1aC(ionald, E. J. Reuort of the R. --- ner.z: :!csoital of the El ?aso County :teic~iLySc L_- - U Procrs-, 19:4-1961. The Universitv of Texas M. ~. .~.. ~_ or. !ospi, ~,r.<I ...^or Insatitute, 26 p,:yes, 1963. Sp. %+.a .:,)nalJ. E. J.. R,,aort .)? ; a rZnc^-r ~: ~ _ i the .ibC_ato: of the ~i t3sCJunt :•1o!!1CC: - __ - :rsci, iy4Y- Coi. :hC G;1lvcrs.ty OC __.._' .. .. n~erson ::oaa:tai and Tua:or Institu~e, 29 pages, 190~. 3'_. tac~ocald, E J.. 2eaort _` the C?nc: '-,;:c --r Clinic o.` the S1 ;o Countv iiow-U_-• ?r,.ran~a- 961. T.. .i;nt•-rers_ty cr .. - =.nderson aas;its anaTunor Insti-ute, 27 ?aaes, :96:~ "02. Macdonald, E. J.: Reeort of the Cancer 3eqist-: c' the Providence Memorial Hospital oE the El Paso Count :•- :c.a'- Societv Foilow-Uo Proaram, 1 44- 961. T e Universitv cf Texas M. D. Ar.aerson Hospita and Tumor Institute, 31 paues, 19~3. 83. Macdonald, E. J.: Section Editor, Epider..iolccr Chapter, Year Book of Cancer, Year Book Medical ?ublisiers, Inc., C~icago, Ib inois, 1962-1963 series, 374-390, ijc:. 8d. Rose R. G., Hartfield, J. C., Kelsef, M. P., ar.c: Macdonald, E. J.: The Association of Thyroid Cancer and Prior Irradiation in Infancy and Childhood. J uclQr.r 4:249-258, 1963. 35. Macdonald, E. J., Griffin, A. C., Hopkins, C. Smith, L., Garrett, H., and Black, G. L.: Psorsicn ?... laxis Avainst Skin Cancer: :2eport of Clinical Trial :. J Invest Derm 41:213-217, 1963.

592 aacucr.~'_~ , Publications (con't) -8- Eleanor j. 86. Hopkins, C. E., Belisario, J. C., Macdor.ald, ~. J., and Davis, C. T.: Psoralen Prophylaxis against Skir Cancer: Report of Clinical Trial II. 'J Invest De:-:, 41:.4):219-233, 1963. 87. Macdonald, E. J., and Bubendorf, E.: Some Epidemiologic Aspects of Skin Cancer. In Tumors of t'r.e Skin, A Collection of Papers Presented at the Sevent: Annual Clinical Conference on Cancer, 1962, at The Universi_; of ':exas y. D. Anderson Hospital and Tumor Institute. C:::c<:.;c, Illinois: Year Book Medical Publishers, Inc., 23-65, i35;. 88. Macdonald, E. J., Hart, M. : The El Paso Y.,2di::al Society FolLow-Up Program. In Year Book of Cancer, Y~ar Book Medical Publishers, Inc., Chicago, Illinois, 531-551, 1964. 89. Macdonald, E. J.: Section Editor, Epidemiology Chapter, 'iear Book of Cancer, Year Book Medical Publis",ara, Inc., C::icago, I linois, 9 3-1964 series, 399-416, 1564. 90. Macdonald, E. J.: A Reoort of the Cancer of St. Elizabeth's Hospital, Houston, Texas, 134 -1?6=. The University o Texas M. D. knderson !iospital ar.d `°.:-cr Institute, 1965. 91. Rutledge, E. N., ^letcher, G`. H., and :.acdon;l-', J.: Pelvic Lymphadenectomy as an Adjunct to Radiatior. Therapy in Treatment for Cancer of the Ceriix. lm J:?e_-._ Rad Theraav and Nuclear Med. 93:(3):60'7-014, 1965. 92. Burns, B. C., Rutledge, F., Copeland, M. M., Burrus, R., and Macdonald, E. J.: A Retrospective 'ieic Trial for Comoarison of Clinical Classifications of Carcinoma of the Cervix. Sura G•.•n ar.d Obstet, 120:(3,: 553-559, 1965. 93. Macdonald, E. J., and Murphy, M. C.: Fac.,zra .:n the 3riden:olow' of Cancer in Ar:cansas. J Arkans'::: 61:(11):382-391, 1965. 94. Macdonald, E. J.: Section Editor, Epidemioiog-; Chapter, 'iear Book of Cancer, Year Book Medical Pu~lis;:rs, . Inc., Chicago, Illinois, 19364-1965 series, 451-455, ='i5` 95. '•lacclonala E. J., Nurphv, N. C, and i•iall-.~;t•.:l, D. G.: C~~narison-of Cancer t•lcrtality Rates in ':'exzs the Unitu.l Statos, 1940-1~59. Mud Record and Anr.u.:1 59:(21:71-74, 1966. i'cbl.cacion~ (ccn't) 96 . Mac:loca1.:, ::apter, YOar 3ook oi Inc., Chicago, illinc 97. Macdonald, of 3kin Cancer. J Ar. 19(7. 93. Fiorentino, :•1.: Le'.:;emia _ evale T''a Reoort of 3ioloqv 99. Macdonald, ~ Car,c~.:r Reqisr.rY c :eyas, Th aospital and ':umor In 100. 5?scdonald, '.~_•~ ional Pitterns in Cancer, 20:(5):617-62 101. Clark, R. L ~. E. ,;r. / Hill, C. ar.d lnhita, E. C.: Th .. S. t•L,cCamb and G. T:;e killiams and Wilk 102. Macdonald, Head and Neck, MacCom 'aLtlmor•_, :•taryland: _967. 103. Macdonald, Heard. The Cancer Bu 104. Fletcher, G Evaluation of Kilovol In Excerot3 Medica In Froceedincs oc t. e .<I Ac:ster am, The ::etner 105. Macdonald, In Cancer of the Gast ^3oers Presente at t Cancer, 1965, at The aospital and Tumor In Inc., Chicago, Illino

io, J. C., Macdonaldn Prophylaxis againsz Trial II. "J Invest De=-:, 3ubendorf, E. : SoMe icer. In Tumors of t^e .sented at t e Sev ent: icer, 1962, at The Universi:y and Tumor Institute. Lishers, Inc., 23-65, 196;. , M.: The El Paso Yedical ear Book of Cancer, Year hicago, Illinois, 531-55', tion Editor, Epideaioicc:; ar Book Medical Publishara, 64 series, 399-416, 156•i. eoort of the Cancer ston, Texas, :derson Hospital and '__-,cr :her. and is an Adjunct to Radiatio:f of the Cer iix. ;+-: J.'.o_-- 3:(3):601-614, 1965. ., F., Copeland, M. M., A Retrospective Field 1•Classifications of :,vn ar.d Obstet, 120: ( 3 ~ : Murphy, M. C.: F.i ~ r:cansas. J Ar':ans.::: ction Editor, Epidemio1oa•Y ear Book Medical ?uolis;,:rs, 965 series, 451-455, !i63. phv, M. C, and t eLlir.y _ca, .~ality Rates in ':e::as M~d ttecord and :,nr.u,, ls , 593 P:::,1:CaCiJ[:3 ICGn't) -9- ri.Edncr i. 90. ~tacio::a1;, E. J.: Section Fdit~).-, cniuc::i:1. C: apter, Zear Book of Cancer, Year 13cok Inc., Chicago, illinois, 19ti5-1966 series, 459-43G, 1,:1. 97. Ltacdonald, E. J.: Some f'niciemioloqicnl of ;kin Cancer. J Am Med Women's Asscc, 22:(a) :235-=;:, 19(7. 93. Fiorentino, :4., Macdonald, E. J., and Toioud' :•1.: Leu;amiz ,revalence and Possibie Clusters in Haus ,n. Te:c Pepnrt n= 3ioloc7v and Med, 25:(2) :189-204, 196'. 99. :4acdonald, E. J. : A Twenty-One Year Re::c_t o' o Canc,Recaist_y of the Santa Rosa 1'.osoital, Sa zCtor.'_o, "exas, 1,j44-1364. The Jniversity aT Texas M. D. n.^c:c:rson Iospital and Tumor Institute, 83 pages, 1967. 100. Macdonald, E. J., Wellinqton, D. G., and `,•:ol°, P.G.. ;'.•_•jional Patturns in Mortalitr from Cancer in the U. S. ::ar.ce:, 20:(5):617-622, 1967. 101. Clark, R. L: Cole, `I. W. Fuller, L. M. ,. euls,,. E. .'r. ai11, C. S., Jr., Ibanez, M. L. Kacdonal;' ar.d White, z. C.: Thyroid. In Cancer of the Head and :: S. 'd:,,;Co::ib and G. H. Fletcher, Ed. Batimcre, b1.:.rvL':r., The williams and Wilkins Company, 293-327, 1967. 19.. >facdonald, E. J.: Epidemiology. In Car.cer o= Head and Nec'-~, MacComb, W. S. and Fletcher, G. !:., -~. _+attimore, :taryland: The Williams and Wilkins ComFany, 1-2=, _567. 103. Macdonald, E. J.: Papers I would Like to Have Heard. The Cancer Bulletin, 19:(3):59-61, 1967. 104. Fletcher, G. H., and Macdonald, E. J.: Clinical Evaluation of Kilovoltage Versus Megavoltage Irradiation. In L•r.cerot3 Medica International Conaress Series :: . 105, roceed:.ncs oc the XIth International Con ress o: Raaic'_ A~aster am, The ::ether an s, 0- , _o . 105. Macdonald, E. J.: Epidemiology of Gastric Cancer. In Cancer of the Gastrointestinal Tract, A Collection of naoers Presented at the Tenth Annua Clinicai Conference on Cancer, 1965, at The Universitv_ of Texas M. D. Anderse~n Hospital and Tumor Institute. Year Book Medical Publis"ara, Inc., Chicago, Illinois, 233-268, 1967.

594 Publications (con't) -10- Eleanor J. :•iacdor.ai_' 106. Macdonald, E. J.: Multipl~ Primaries. Ir. Ca::cer of the Gastrointestinal Tract A Collection of Papers ?rescat~;' at the Tenth Annual C inica Conference on Cancer, ?6-, at The University of Texas M. D. Anderson Hospital and Ts:,c_ Institute. Chicago, Illinois: Year Book Medical Pul~iis.`.:rs, Inc., 269-282, 1967. 107. Clark, R. L., Moreton, R. D., Healey, J. ., and Macdonald, E. J.: Rehabilitation of the Cancer Patient. Cancer, 20:839-845, 1967. 108. Macdonald, E. J.: Section Editor, Epidemio1o47 Chapter, Year Book of Cancer, Year Book Medical Publishers, Inc., Chicago, I inois, 1966-1967 series, 374-393, 1967. 109. Macdor.ald, E. J., and Wolf, P. ... Epidemiology of Gastric Cancer. In E~demioloaical, Experimental, and Clini~al Studies on Gastric Cancer. Maruzen Company, Lzc., Publications (con't) 116. Albar., W., Sjr•~ey St'sdies in Hou Contacts. The .',meric 117. Rot,erts, R. Social Status, Ethnic ?coiogical Analysis. 23, 1970. 118. Macdonald, i . Reqional Patterne 1944-1966. The Cancez 119. Macdonald, E of Breast Cancer 1971. 1971. Tokyo, Japan, 3- , 1968. 127. Macdonald, E Chaot Y B k f er, ear oo o i10. S:acJcnald, E. J., and Wolf, P. F.: Comparati•r•- -- :nc., Chicago, I o1s Incidence o` Ca<.-:er in Three Regions in Texas. In A'r.tu=::c Proble.^.+e .ius Gebiet der Cancerolecie II, Proceacin r 121. Macdonald, E c ' - -''.--." ~'COnd ;:OSluID C'~ vdrP.:aR Cancer Re:iElrCa (:cntE'r,~, ' C_iented Bibliography 1CS, Germany. 'r.eidelbeza, Germany: ,Springer-verlag, 9"- .. Epidcmiology, The U 1965. and Tumor Institute, H 111. ..acdonald, E. J, and aolf P. c.. , of ::ancer 'tortality Rates Bet«een 3order Provinces o_' _-.•_.... 122. Macdonald, :. :esurun, H. a.: The I and the A::}acent States. Med Record and Ar.nals. Gi:2C5- '-e Cervix in El Paso 209, 233, 1968. 're American Medical W 112. ..:.caonald, E. J.: The Surv~o: Cancer in _1. . 1~~;4-19E6. 'resent Status and Resuits: June 30, i363 123. Macdonald, E F:uston, °.'?:cas: 9' e University of '•i,2xas M. 0. Anuersor. 1372. The Cancer Bull Hospital and Tumor Institute at Houston, 456 pages, 1963. 124 113. Macdonald, E. J.: Section Editor, Epidec•'_o_cq1 Chaoter. .a r eook of Cancer, Year Book Medical . war.cuso, T. . "_7ration and Cancer M( ~ Sccthern Born Non-; .nc., Chic~yo, _11inois, 9 7-1968 series, 450-46', _953. ::r.:•ir~nmenta'_ fiealt: 11•t. Macdonald, E. J.. Section EJito: E,r.idc^:iolo~, Char,ter, :'ear Oook of Cancer, Year Book Medical Publishe_s, Inc., Chicago, il inois, d 9-440, 1969. 113. '•!acdonald, E. J.. Section Editor, Epid•_^iolcg7 Cnaoter, ':'esr 8ook of Cancer, Year 9c^.R Medical Publ•_s:^ar=, Inc., Chiz~:,yo, I_ inois, 4-494, 1970. Ed., Un_vers_ 125. Macdonald, E. =tat.:s uc Epidemiology ='3 i<arger, Basel) 19' :26. Macdonald, E. ~ • ~ikstrom, S., and ( -3r.cer t,a,ony Women in L _ the lmerican Medica:

: Prim3ries. I.^. Caccer :ecticz of Pa_ ?rescnt~_ ice on Cancer, -?6:, at )n Hospital and T1-c: Book Medical Publishers, 3., Healey, .,. , and the Cancer Patien=. Editor, Epidemiolo,;;' ook Medical Publis`:ers, aries, 374-393, 1967. P. ... EpidemiologV al, Experi:aen_al, and Maruzen Compa ny, Lt::. , P. r.. Comparati . - in Texas. In Aktu:':e -cie II, Prcceacin,::: -- search Center, nqer-Veriag, 97-._. Co^p~ _-~.. P. F . . A rder Pro•: inces o' and Anna'_s. 61:2" F.- v~ of Cancer i1 "e: cs: June 30, i 9 b3A exas M. D. Anuerson :ton, 456 pages, 1963. t Editor, Epide:^'_ol ;1 Book 39ediCal :eries, 450-462, 1953. . i rditor, ~pidemioloc.; 3ook Medical Publisner5, )69. i Witor, Epideni--_cgY 3cck Medical Publ'-s^or=, )70. 595 Publications (con't) -11- Eleanor J. :daci~a_:.c 116. A1bar., W., and Macdonald, E. J.: elot•? i.. '`•.o Survey Studies in fiouston Not Involving House to :icuse Contacts. The Iunerican Statistician, 24:(4):31, 1970. 117. RoLerts, R. E., McBee, G. W., and :•Iacdonald, : Social Status, Ethnic Status, and Urban Mortality: An Ecological Analysis. Tex Reo_orts on Biol and Med,.22:13- 23, 1970. 118. Macdonald, E. J., Johnson, M. S., and Murohv, A.: Reqional Patterns in Morbidity from Melanoma inT~xa::, 1944-1966. The Cancer Bulletin, 23:(3):51-55, 1971. 119. Macdonald, E. J.: Observation on the Epide-io:ocy of Breast Cancer 1971. The Cancer Bulletin, 23:102-100, 12Q, 1971. 120. Macdonald, E. J.: Section Editor, Epide.mio:cg;i Chsc*_er, Year Bcok of Cancer, Year Book Medical Putlishers, Inc., Chicayo, I linois, -357, 1971. 121. Macdonald, E. J., and McGuffee, V.: Epidemio1c;:ca.:- • Criented Bibliography of Mel'anoma, 1967-1971. The Gauart-,.~nt of Epidemiolegy, The University of Texas M. D. Anderscn ::osn_it~: and Tumor Institute, Houston, Texas, 1972. 122. Macdonald, E. J., Morgan, J.: R. , Hart, !•t. S, ac.i Jesurun, H. a.: The Incidence and Curability of Cancer of the Cervix in El Paso County, Texas, 1944-1967. ,;cur::a'_ of the American Medical Women's Association, 28:(1):19-2r; -. 1911. 123. Macdonald, E. J.: Epidemiology of Colon-Rectai. Canca•- 1972. The Cancer Bulletin 25:(2):33-41, 1973. 124. uar.cuso, T. F., Coulter, E. J., and Macdonald, ~. J.: '^.iqration and Cancer Mortality Experience - A Study of tiative and Scuthern Born Non-White Ohio Residents. Trace Substan=as cn•:ircr,mental Itealth - VI. 1973. A Symposium, D. 3. :iempni:i, Ec, t.n_versity of Missouri, Columbia. 125. Macdonald, E. J., McGuffee, V., and White, E.: Status uf Epidemiology of M.elanoma 1971. Pigment Cell, 1:222- 228 (Xar7er, Basel) 1973. 126. :tacdonald, E. J., Lichten3tein, H., Nooner, D., Flory, D., Wikstrom, S., and Oro, J. Epidemioloqical Factors in Lunq Cancer Among Women in El Paso County, Texas, 1944-196). Jc::rnal of the „merican Medical Women's Association, 28:(9)::59-•;b7, 1973.

596 Publications (con't) -12- 'cleancr .;. ".dcdc,naic 127. Macdonald, E. J.: Epidemiological Aspects of Gastric Cancer. JAMA, 228:884-886. 1974. 128. Macdonald, E. J.: Epidemiology of Melanoma 1972. The Treatment of Cancer of the Skin and Allied Oiseases. In V^'.. : Prro ress in Clinical Cancer, ed. Ariel, I. M. Grune and Strar.tcn. pp. 139-149, December, 19 . 129. Macdonald, E. J.: Cmocho:vski, L. L., and Jesurun. H. :' . A Study Among Lactating Latin and Anglo 'domen in El Paso County. to Oetermine Presence of Virus-Like Particles in the F1ilk. Procrar: : Resumenes de Cernunicacions. 2nd Duran-Reynais International SvTr• '/ira Re ications and Cancer, arce ona, Spain, June 2-Z3, 1: 3. Abstract No. a eres Graficos, Labarotoria P.E.V.Y.A. 130. Macdonald, E. J.: Incidence of multiple primary canc•_;• ir, three regions in Texas 1944-66 (Proceedings of the Vth Perugia a~acr_rn~sl International Conference on Cancer. Perugia University, 1973). In Prima rr Mali nant Tumours, ed. Lucio 5everi, Division of Cancer Resear:n, s r g a, taly, pp. 123- 42, 1974. ei 131. Macdonald, E. J.: Ethnic and Regional Consicerations in Epideniology of Breast Cancer. Journal of the American Medical Association, March, 1974, 30:(3 : 05- 3. ~ 132. Smolensky, M. H., Samueloff, S., Harlevy, 8., E. and Reinberg, A.: Circannual Heart Mortality. An attempt to possible endogenous and exogenous factors in seasonal variations in ^e}r: deaths. Israeli ,7nurnal of Medical Sciences.' 12:318-827, 1576. ,33. '4acdonald, E. J.• Association 5etween Cancer Eye and So:a Radiation. In I.-.jeacts e` Climatic Chance on 'he 9iosphere. Clinatic Imoact Assessment Program, Monograph 5, Part~traviolet RaCiaticn Effects, Department of Transportation. Climatic Impact Assessment ?rcgror-, Washington. D.C. pp. 6-20, September, 1975. ,-` 13a. Macdonald, E. J.: Epidemioloqy of Skin Cancer, 1975. ~. collec'ien of papers presented at the 20th Annual Clinical Conference o-: Cancer, 1575. at The University of Texas S,vstem Cancer Center M. ~_ ~ncerser. 'ir oital and Tumor Institute, Houston, Texas. Year Book ".ecical ? b':isners, :nc., Chicago. ;11., 1976, pp. 27-42. 13=. 'Iacdonald, E. J.: Incidence and Epidemiology of t4elano,:a 'n Texas. :A collection of papers presented at the 20th Annual Clinical i.onference cr, Cancer, 1975, at The University of Texas System Cancer Cester '4. 0. And%rson Hospital and Tumor Institute, Houston, Texas. Year 800%: Medical Publ;shers. Inc., Chicago, I11., 1976, pp. 279-292. 136. h'acdonald, E. J.: Derlograuhic Variations in Cancer in 2a~aticn to Industrial and Environmental influence. _nvironmentai Healtn P,'s ec_'v2s, 17:153-166, 1916. ?uolications (cont'd) 1'_7. ,•lacdonald, E. J.: Nouscon, Texas. ;ournal of tne 3i:.,7_-395, ih:toL~r, 19io. 133. Nacdonald, E. J.: -;mors in Children in Texas. T. ?rcce=-dings of 'J:tt: ?erticia Quac ancer. Perugia, uctooer, 1973. 3y. ;:acconald, E. J. E C ncer in Texas: incidence Ana' Lo,:ati,on. Raven , ress, i;ew Yori 1110. ,lellington, 0. G., Cancer '?ortaliti: Environmenta' ---. ;;dar 'lork, J~;ne 1~, 1979- 141. l-acdcnald, E. J.: ~idemiology Stuuies of Low-Leve eer.inn of The Ac:erican .assoeia: ~ouston, Texas, 1979. ._ , ~~. ''!dCdonald, E. J.: _aiiz,-.ioic~y in ~ Cancer HosoitC 31, .o. 2, ~S p. S-1s 19, Spc aei;incton. Dorot: F.: Zt^n.ic Effects in U`. ~•e Cancer 5ul it n, Vo1. 31, No. 144. Macdonald, E.J.: 't Lung Cancer. In Thoracic Neoplasr Grillo. Raven Press, 1980. In Pre

~ Eleancr ,.. "acJc.nai;i )logical Aspects of Gastric ;,,;n; er. )lugy of Melanoma 1972. i Allied iliseases. :n '•!^,'. i, I. 1'1. Grune and Strattcn. (i, L. L., and Jesurun. H. :' . ) 5lomen in El Paso County, T~,.<'°s rticles in the Milk. Procrar:J -Reynals International Sv:m st,::c: 19 ~, ia, pain, June 21-Z3, 3barotoria P.E.V.Y.A. :e of multiple primary canc•_:• ir, Jings of the Vth Perucia Quadr<nn'a rugia University, 197:i. In Severi, Division of Cancer Resear.,:r 3nd Regional Considerations in 1 of the American Medical dcre•~'~ 3. f, S., Harlevy, B., rtality. An attempt to ide°ti': ors in seasonal variations in ^ea:= iences.' 12:318-827, 1976. .tion °etween Cancer Eye an,: So:a :na_e on the 9iosahere. Climatic i, Part 1- U traviolet Radiaticn , Climatic Impact Assessment ?rcgr-m, 1975. . r. ioloqy of Skin i;ancer, 1975 20th Annual Clinical ConfarS-ca o^ <as System Cancer Center M. 0 ;.^•cerson , Tecas._.Year 3ouk ':ecical ?-1':is^ers. ice and Epidemiotngy of t4elano,:a ':1 ted at the 2Gth Annual Ciin`.cal iversity of Texas System Cancer Cenzer titute, Houston, Texas. Yea'r 2o,04 1., 1976, pp. 279-292. suhiC 'dariations in Cancer in ?9~ati0n ence. Environmental Healtn P':,SMcc-~ve.` 597 ?uolications (cont'd) -13- Eleanor J. ''.acdonald 127. '•iacdonald, E. J.: Air Pollution, Democrapny, Cancer: Houston, -exas. Journal of tne American Medical Women's Associat'.on, 3i:37:-395, dctoL12r, 1':70. 133. lacdonald, E. J.: Re_lional and Etiinic Oifferences in -jmors in Ciiildren in Texas. Tumours of Earlv Life in ~4an and Aninals. ?rcce_din:s o~ 1:t^ ?eracia Quadrennia :nternationa Conrerence on Cancer. Perugia, uctooer, 1973, pp. 13-44. :.y. ;'acaona'd, E. J. and Heinza, E. B.: EpideTiolooy of Cancer in ?axas: inci~ence .0.nalvzed by Tyoe, Ethnic Grouo ane ~eo5rac:nic ,ocation. Raven .ress, :aw York, 19~3, Pp. 140. .tallington, D. G., Macdonald, E. J., and :lolf, P. F.: Cancer "ertalit : Environmental and Ethnic Factors. •4cademic Press, ;:aw 'lork, ;une 1S, 1979. 141. .-iacdcnald, E. J.: Standards for Eoidemiolo4v Research. =ridemioloay St~uies of Low-Level Radiation Exposure. A?aper. Annuul :eetinn of 'he ~.,:er'.can .assqciation for The Advancement of Science. iouston, Texas, 1979. '42 '•'acdonald, E. J.: Foundina of the First Deoartc.ent of ~ide;,iolcny in ;: Cancer Hosoital. hPaoer. The Carc~r 3u etin, ~~ p 5-13-~19, Special Edition, 1979. 1113. :.ei:incton. Dorothy G.. Macdonald. Eieanor ~a_ricia F.: -t^r.ic Effects in US Cancer '•!ortaiity ~'oaeis. ~OaFer. . -;~e Cancer 3ul-~n, 10 . 31, No. ,:119- , 19 9~~ 12 144. Macdonald, E.J.: Present Direction in the Epidemiology of Lung Cancer. In Thoracic Neoplasms, edited by Drs. Chan Choi and Hermes Grillo. Raven Press, 1980. In Press. I