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December 30, 1939


JAMA. 1939;113(27):2405-2410. doi:10.1001/jama.1939.02800520031006

In discussions of the relationship of climate and geography to health, attention has been especially directed toward communicable diseases. This perhaps is to be expected, since these are the diseases against which most control measures have been directed. Geographic variations in the prevalence of conditions due to other possible factors, however, have not been overlooked. Of particular interest with respect to cancer is the fact that Dr. John S. Billings pointed out the wide geographic variation in cancer mortality as revealed by the United States Census of 1880 (fig. 1). Although the data were admittedly incomplete, they indicated that cancer most frequently occurred among persons living in the states extending from New England to the Great Lakes and in the Pacific Coast states.1

Among the items taken up for study by the United States Public Health Service after the passage of the National Cancer Institute Act of 1937 was