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International Journal of Epidemiology 2002;31:21-22
© International Epidemiological Association 2002
Reprints and Reflections |
Commentary: Helicobacter as the ‘environmental factor’ in Susser and Stein's cohort theory of peptic ulcer disease
University of Western Australia, Department of Microbiology, Room 1.11, L Block, Queen Elizabeth II. Medical Centre, NEDLANDS WA 6009, Australia. E-mail:admin@hpylori.com.au
I am not certain how I became aware of the paper by Susser and Stein in Lancet of 1962, I suppose it was from references in another article on peptic ulcer.1 It did amaze me that 20 years before the discovery of Helicobacter pylori the idea of a cohort effect in peptic ulcer had been considered, and various predictions made. Although brilliantly correct about an environmental effect peaking near the turn of the century, Susser and Stein still exhibited some of the tunnel vision regarding ‘stress‘ in all its forms as a peptic ulcer aetiology. One of their hypotheses for changes in ulcer mortality involved urbanization stress,
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