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The epidemiology of stomach cancer: correlating the past with the present

BMJ 2000; 320 doi: (Published 24 June 2000) Cite this as: BMJ 2000;320:1682

Socioeconomic influences in early life can influence mortality in adult life

  1. David Forman, professor of cancer epidemiology (,
  2. Karen J Goodman, assistant professor of epidemiology (
  1. Academic Unit of Epidemiology and Health Services Research, School of Medicine, University of Leeds, Leeds LS16 6QB
  2. School of Public Health, University of Texas-Houston Health Science Center, Houston, TX 77225, USA

    Papers p 1705

    Studies of geographical correlation have low status within the canons of evidence based medicine. At times, the low status is not without reason—most readers will be familiar with presentations in which the equivalent of the international variation in childbirth is attributed to the nesting patterns of storks. Every so often, however, a simple correlation synthesises a complex web of research hypotheses and findings and shows a striking relation not previously appreciated.

    Leon and Davey-Smith present one such picture in this week's BMJ (p 1705). Their graph plots the mortality from stomach cancer in 1991–3 among 65–74 year old men against infant mortality in 1921–3 in 27 countries and shows a strong relation between the two. The strength of the correlation is nearly identical for mortality from stomach cancer in women and changes little when adjusted for current (1991–3) infant mortality in each country. In contrast, the correlation between …

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