© 2002 by Society for the Social History of Medicine
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The Genesis of the Notion of Stages in Oncology: The French Permanent Cancer Survey (19431952)
1 UFR des Sciences de l'Homme, Département de Sociologie, Université de Caen, Esplanade de la Paix, 14032 Caen cedex, France. E-mail: menoret{at}sc-homme.unicaen.fr
This article analyses the Enquête Permanente Cancer (EPC) (Permanent Cancer Survey) which organized the recording of cancers in France from 1943 onwards. This survey used a new classification of tumours and introduced the notion of stages. For its French authors, defining the different stages of the disease was primarily a question of methodological necessity: standardizing and giving relevance to data which until then had been disparate and scarce. However, by correlating the timing of the initial diagnosis of cancer with the length of asymptomatic periods after anti-cancer treatment, differentiated survival rates could be obtained. For each type of cancer, each stage could be shown to correspond to a greater or lesser probability of length of survival. This notion of stages, which was rapidly adopted on the international level as a tool for probabilistic reasoning, was not adopted for the purposes of prognosis in France until the 1960s.
Keywords: cancer; medical uncertainty; statistics; French epidemiology; probability; prognosis; curing of cancers; remission