Research from tobacco industry affiliated authors: need for particular vigilance

S Chapman

doi:10.1136/tc.2005.012427

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Research from tobacco industry affiliated authors: need for particular vigilance

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Re: Courtrooom expert opinions should be published
Frederic Grannis
Published on: 27 January 2006
Courtrooom expert opinions should be published
David Egilman
Published on: 3 January 2006
Japan made a great progress in tobacco control.
Yoshitaka Kiriake
Published on: 21 October 2005

Published on: 27 January 2006
Re: Courtrooom expert opinions should be published
- Frederic Grannis, Thoracic Surgeon
The trial testimony of Sanford Barsky, offered by David Egilman in his email letter to Tobacco Control, provides an illustrative example of why tobacco industry sponsored research should not be published in Tobacco Control or other responsible scientific periodicals. In the testimony Barsky argues for non-tobacco causation of a case of squamous cancer of the lung. Examination of tobacco industry documents housed in the...
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The trial testimony of Sanford Barsky, offered by David Egilman in his email letter to Tobacco Control, provides an illustrative example of why tobacco industry sponsored research should not be published in Tobacco Control or other responsible scientific periodicals. In the testimony Barsky argues for non-tobacco causation of a case of squamous cancer of the lung. Examination of tobacco industry documents housed in the Legacy Tobacco Documents Library http://www.legacy.library.ucsf.edu reveals that the tobacco industry organized and funded an effort, Council for Tobacco Research (CTR) Special Projects (SP) 47 and 110, to recruit eminent physicians to identify cases of epidermoid (squamous) carcinoma of the lungs in non-smokers. [1], [2] This search was important to the tobacco industry because of public testimony by prominent pathologists like Oscar Auerbach MD that he "had never seen a case of squamous cancer in a nonsmoker". [3] The stated purpose of SP-110 was "To demonstrate that epidermoid lung cancers do occur in nonsmokers and thus refute assertions that these cancers occur only in smokers." [4] This research effort was led by pathologist Lauren Ackerman MD and included a number of thoracic surgeons, including Society of Thoracic Surgeons president Lyman Brewer III.MD and Thomas Burford MD Chair of Thoracic Surgery at Washington University. Ackerman, a pathologist at Washington University was the recipient of a $3.6 million tobacco industry research grant. [5] Also involved in SR-110 was Yale epidemiologist Alvan Feinstein PhD, who received more than $2 million from the industry during his long career. Other participants in the study are listed in a footnote below. Of these individuals, only Feinstein ever published on the topic. He reported after a review of medical records that he had found 17 cases of epidermoid cancer in non-smokers. This assertion prompted a review and 1970 publication by Yale pathologists Raymond Yesner and N.A. Gelfman who determined that none of Feinstein's cases were, in fact, epidermoid cancers. Remarkably, although he was a coauthor on this publication, in two letters to the editors of JAMA and the Medical Tribune, Feinstein "regretted the premature publication" and disassociated himself from Yesner's conclusions, stating that he did not believe that epidermoid cancer was a "tobacco cancer" based upon his interpretation of data. [6][7] Finally, in 1973 another reexamination of 449 Yale lung cancer cases by the same authors confirmed that the incidence of squamous and small cell lung cancers is very uncommon in non-smokers (approximately 1%). There were no cases among non-smoking men. [8] In 1974, Feinstein took a new tack, suggesting that the reason that there was an increase in lung cancer in smokers was a "bias" on the part of clinicians who were more likely to consider a diagnosis of lung cancer and initiate testing for the disease in smokers. [9] No publication on this topic by any of the other researchers involved in SP-110 could be found in a search of the Index Medicus. The clear implication is that none of the experts could find cases of squamous lung cancer in non-smokers in the records of their medical centers. This should cause no surprise to clinicians and pathologists experienced in the care of lung cancer, who know that cases of such cancers in non- smokers are rare. It is also reasonable to assume that, if the SP-110 and SP-47 investigators had identified cases of squamous lung cancer in never-smokers, the results would have been published and trumpeted by the industry in courtroom testimony. The fact that the results of SP-110 were not published reflects the willingness of the tobacco industry to stifle publication of adverse results, and represents a clear and typical example of the insidious and self-serving nature of tobacco industry funded research. Good science involves the publication of all results, not just those that serve the agenda of a killer industry. Appendix:
Physicians and scientists mentioned in documents as participating in these CTR "Special Projects"included. Robert E. Stowell MD Dean Davies Lauren Ackerman MD St.Louis MO Avrill Liebow MD New Haven CT Samuel G. Taylor MD Chicago IL Russell Irwin MD San Diego CA William H. Sheffield MD Thomas Burford St. Louis MO Haynes Shepherd San Diego TS Homer Peabody MD San Diego CA John R. Kiser MD San Diego CA Alvan Feinstein MD New Haven CT Doris Herman Los Angeles CA Lyman Brewer MD Los Angeles CA
References:______________________________ [1]http://legacy.library.ucsf.edu/cgi/getdoc?tid=zxz95a00&fmt=pdf&ref=res ults ; "Special Project # 47." Bates # 92613988 [2]http://legacy.library.ucsf.edu/cgi/getdoc?tid=aqw90c00&fmt=pdf&ref=res ults ; "Special Projects" January 1, 1968. Bates #995007392 [3]http://legacy.library.ucsf.edu/cgi/getdoc?tid=dod3aa00&fmt=pdf&ref=res ults Memorandum Leonard Zahn and Associates "American College of Surgeons". Bates # unknown. [4]. http://legacy.library.ucsf.edu/tid/ydm06a00 "Collect Cases of Epidermoid Lung Cancer in Non-Smokers". Bates # 955008212 19660226 American Tobacco Company [5]http://legacy.library.ucsf.edu/cgi/getdoc?tid=dzg33f00&fmt=pdf&ref=res ults ; "Washington University March 1971". Bates # 680601980 [6] Feinstein AR. Smoking and cancer morphology. JAMA. July 6, 1970, 213:131 [7]Feinstein AR. Smoking-histology study. Medical Tribune 1 June 1970;33:11. [8]Yesner R, Gelfman NA, Feinstein AR. Reappraisal of histopathology in lung cancer and correlation of cell types with antecedent smoking. Am Rev Resp Dis 973;107:790-7 [9]Feinstein AR, Wells CK. Cigarette smoking and lung cancer: the problems of "detection bias" in epidemiologic rates of disease. Trans Assoc Am Physicians. 1974;87:180-5
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Conflict of Interest:
None declared.
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Published on: 3 January 2006
Courtrooom expert opinions should be published
- David Egilman, Physician
As Professor Chapman has noted some have questioned the merits of publishing papers that the tobacco industry funded. In the spirit of Justice Brandeis who noted that, “Sunlight is the best disinfectant” I believe that more not fewer tobacco industry consultants opinions should see the light of day. For example I believe that court room opinions offered under oath, by tobacco hired historians, physicians and others sho...
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As Professor Chapman has noted some have questioned the merits of publishing papers that the tobacco industry funded. In the spirit of Justice Brandeis who noted that, “Sunlight is the best disinfectant” I believe that more not fewer tobacco industry consultants opinions should see the light of day. For example I believe that court room opinions offered under oath, by tobacco hired historians, physicians and others should be published as often as possible perhaps as a regular TC offering with pro and con commentary. This would permit real peer review of opinions that have great importance in the creation of policy. I offer your readers an example. Dr. Sanford H. Barsky gave this opinion on the case of Mr. Vandenberg, a seventy-nine year old ex-marine and postal worker who had a 75 pack-year smoking history.
“My opinion is that he has a fairly well differentiated squamous cell carcinoma of the lung that's arising within a bronchiectatic focus of the lung and that's going through the stages time [including] the stage of metaplasia, dysplasia, in situ carcinoma and invasive carcinoma… I think the squamous cell cancer is arising within this bronchiectatic focus. I think the chronic inflammation and irritation of this focus is what's giving rise to the squamous cell cancer; that it's a peripheral squamous cell cancer, away from the main airways and that his tobacco smoking is not causally related to the genesis of this particular tumor.” He noted that, “no one has mentioned the term, bronchiectasis in the medical records.” And based his opinion, “primarily on pathology” buttressed by case reports and Spencer’s Textbook of pathology that had “commonly” note the association between bronchiectasis and lung cancer. He went on to state that smoking did not contribute to cause the cancer.
I invite your readers to shed light on this opinion.
I serve as an expert witness in Tobacco litigation
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Conflict of Interest:
None declared.
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Published on: 21 October 2005
Japan made a great progress in tobacco control.
- Yoshitaka Kiriake, Physician
When Hong and Bero published their study �"How the tobacco industry responded to an influential study of the health effects of secondhand smoke�" in 2002, I was supporting the law suit against a railway company to get smoke-free environment for workers and passengers in Japan. At that time, non-smokers had been annoyed by secondhand smoke for a long time regardless of our many claims. The company had been denying the harmfu...
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When Hong and Bero published their study �"How the tobacco industry responded to an influential study of the health effects of secondhand smoke�" in 2002, I was supporting the law suit against a railway company to get smoke-free environment for workers and passengers in Japan. At that time, non-smokers had been annoyed by secondhand smoke for a long time regardless of our many claims. The company had been denying the harmful effects of second hand smoke, because tobacco industry affiliated authors were publishing many studies which denied the health effects of tobacco smoke and these studies were used for the many other tobacco-related law suits by many companies to reject the control of secondhand smoke. So I carefully read the Hong� and Bero study and accessed to the tobacco documents. I thought Hong� and Bero's study was correct, because I found that the company had used many studies produced by tobacco industry affiliated authors to reject tobacco control. Therefore I decided to use the tobacco documents which described the conspiracy of tobacco industry affiliated author for the law suit. Then I and lawyers submitted the evidence to the court. Amazingly, I was successful in having the court admit the necessity of controlling secondhand smoke on January 3, 2005. The court decided that tobacco industry affiliated authors were unreliable and the studies produced by them were incredible. This judgment was an epoch-making success in Japan. It enabled us to introduce more effective tobacco control measures very smoothly. Thanks to Hong and Bero, Japan made a great progress in tobacco control.
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Conflict of Interest:
None declared.
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