David B. Thomas
Dr.P.H., Johns Hopkins University, 1972.
M.D., University of Washington, 1963.
My expertise is in the following areas:
breast cancer epidemiology
cervical cancer epidemiology
From 1978 to 1992, Dr. Thomas coordinated for the World Health Organization (WHO) a collaborative study in 11 countries on five continents. The purposes of this study were to assess the effects of steroid contraceptives and other factors on risks of cancers of the breast, cervix, ovary, endometrium, and liver. The WHO study showed that women are at increased risk of cervical cancer if, prior to marriage, their husbands frequently visited prostitutes and did not use condoms during those visits. Certain strains of human papillomaviruses (HPV) are the sexually transmitted agents that are probably necessary causes of cervical cancer, and Dr. Thomas conducted a subsequent study in Bangkok that confirmed the role of prostitutes as a reservoir of oncogenic HPV strains, and of their customers as vectors for transmission of these viruses to women in the general population. That study also provided evidence that persistence of oncogenic types of HPV, which leads to carcinogenesis, is associated with endgenous and exgenous hormonal factors and smoking, as well as immunosuppression. With the possible exception of Vitamin A, which may inhibit progression from in situ to invasive disease, other co-factors appeared to act earlier in the carcinogenic process.
In 1988, Dr. Thomas initiated a randomized trial of breast self-examination (BSE) in Shanghai, China. More than 267,000 women in 519 textile factories were interviewed to obtain information on risk factors for breast cancer, and randomly assigned by factory to a BSE instruction group or control group. Women in both groups were monitored for the development of benign and malignant breast tumors, and for mortality through 2000. Mortality from breast cancer was the same in the instruction and control groups, providing strong evidence that teaching BSE does not reduce deaths from breast cancer. This study population also serves as a resource for independently funded investigations conducted in collaboration with other investigators at the Center. One such study showed that induced abortions did not alter the incidence rate of breast cancer. Other investigations have included studies of: the determinants of cell proliferation in benign and malignant tumor tissue and in normal tissue adjacent to tumors; the role of nutritional factors in the etiology of benign and malignant breast diseases; the role of breast cancer genes BRCA-1 and BRCA-2 in the development of breast cancer; the possible role in the etiology of breast cancer of polymorphisms in multiple genes involved in hormone biosynsthesis and catabolism, and of genes for certain growth factors and hormone receptors; and the possible etiologic role of electromagnetic field exposure in the etiology of breast cancer. In addition, risks of other types of cancer in relation to contraceptive methods and occupational exposures have been assessed in women in the trial cohort.
Dr. Thomas also conducted a study in Seattle that showed that radiographic densities and certain types of calcifications on mammograms in women under 50 can be used to identify women at increased risk of subsequent breast cancer.
Dr. Thomas is former Head of both the Epidemiology and Breast Cancer Programs at the Fred Hutchinson Cancer Research Center, and former Director of the Cancer Surveillance System of Western Washington which is a population-based cancer registry.
Plans are underway with colleagues to utilize the resources from the studies in Shanghai to conduct additional investigations into the etiology and natural history of breast and other cancers. Studies under consideration include: use of microarray technology to identify determinants of breast cancer development in benign breast tissue and of survival in malignant breast tissue; development and testing of biologically based mathematical models to investigate mammary carcinogenesis.
American Association for the Advancement of Science
American College of Epidemiology
American Epidemiological Society
American Society of Preventive Oncology
International Association of Cancer Registries
Physicians for Social Responsibility
Society for Epidemiologic Research
Honors and Awards
1999, Honorary Member, International Association of Cancer Registries
1996, Johns Hopkins University Society of Scholars,
1994, Fellow, American Association For the Advancement of Science
1990, Fellow, American College of Epidemiology
1994-2000, Program Head, Fred Hutchinson Cancer Research Center, Program in Epidemiology, Public Health Division
1994-1998, Head, Fred Hutchinson Cancer Research Center, Seattle Breast Cancer Research Program
1983-2000, Director, Cancer Surveillance System of Western Washington
Anthropometric and Hormonal Risk Factors for Male Breast Cancer: Male Breast Cancer Pooling Project Results.. Journal of the National Cancer Institute.. 2014.
Occupational exposure to magnetic fields and breast cancer among women textile workers in Shanghai, China.. American journal of epidemiology. 178(7):1038-45.. 2013.
Evidence of a paradoxical relationship between endotoxin and lung cancer after accounting for left truncation in a study of Chinese female textile workers.. Occupational and environmental medicine.. 2013.
Short report: Limited effectiveness of screening mammography in addition to clinical breast examination by trained nurse midwives in rural Jakarta, Indonesia.. International journal of cancer. Journal international du cancer.. 2013.
Reproductive factors and risk of lung cancer in female textile workers in Shanghai, China.. Cancer causes & control : CCC.. 2013.
Occupational exposures and mortality from cardiovascular disease among women textile workers in Shanghai, China.. American journal of industrial medicine. 55(11):991-9.. 2012.
Fruit and vegetable intakes in relation to plasma nutrient concentrations in women in Shanghai, China.. Public health nutrition. 15(1):167-175.. 2012.
Risk of lung cancer in relation to contiguous windows of endotoxin exposure among female textile workers in Shanghai.. Cancer causes & control : CCC. 22(10):1397-1404.. 2011.
Survey on a mammographic screening program in Istanbul, Turkey.. The breast journal. 17(3):260-7.. 2011.
Lung cancer and occupational exposures other than cotton dust and endotoxin among women textile workers in Shanghai, China.. Occupational and environmental medicine. 68(6):425-9.. 2011.
Reproductive history and mortality from cardiovascular disease among women textile workers in Shanghai, China.. International journal of epidemiology. 40(6):1510-8.. 2011.
Unexpected excessive chronic obstructive pulmonary disease mortality among female silk textile workers in Shanghai, China.. Occupational and environmental medicine. 68(12):883-7.. 2011.
Breast cancer management in low resource countries (LRCs): consensus statement from the Breast Health Global Initiative.. Breast (Edinburgh, Scotland). 20 Suppl 2:S3-11.. 2011.
Breast cancer management in middle-resource countries (MRCs): consensus statement from the Breast Health Global Initiative.. Breast (Edinburgh, Scotland). 20 Suppl 2:S12-9.. 2011.
Problem solving for breast health care delivery in low and middle resource countries (LMCs): consensus statement from the Breast Health Global Initiative.. Breast (Edinburgh, Scotland). 20 Suppl 2:S20-9.. 2011.
Physical activity, physical exertion, and miscarriage risk in women textile workers in Shanghai, China.. American journal of industrial medicine. 53(5):497-505.. 2010.
Biomarkers of dietary exposure are associated with lower risk of breast fibroadenomas in Chinese women.. The Journal of nutrition. 140(7):1302-10.. 2010.
Fruit and vegetable intakes are associated with lower risk of breast fibroadenomas in Chinese women.. The Journal of nutrition. 140(7):1294-301.. 2010.
Dietary and stored iron as predictors of breast cancer risk: A nested case-control study in Shanghai.. International journal of cancer. Journal international du cancer. 125(5):1110-7.. 2009.
Dust and chemical exposures, and miscarriage risk among women textile workers in Shanghai, China.. Occupational and environmental medicine. 66(3):161-8.. 2009.
Erythrocyte fatty acids and risk of proliferative and nonproliferative fibrocystic disease in women in Shanghai, China.. The American journal of clinical nutrition. 89(1):265-76.. 2009.
Oral contraceptives and the risk of all cancers combined and site-specific cancers in Shanghai.. Cancer causes & control : CCC. 20(1):27-34.. 2009.
Occupational risk factors for endometrial cancer among textile workers in Shanghai, China.. American journal of industrial medicine. 51(9):673-9.. 2008.
Guideline implementation for breast healthcare in low- and middle-income countries: early detection resource allocation.. Cancer. 113(8 Suppl):2244-56.. 2008.