November 25, 2025
“Cancer is a disease of civilization.”— Stanislas Tanchou, Paris physician, 1843
“The various forms of cancer are becoming alarmingly more frequent.”— British Medical Journal, 1892
“We have made tremendous progress against cancer.”— American Cancer Society, 2020
[Same year: U.S. cancer deaths hit all-time high of 600,000]
[Part 2 of 6]
New parts publish every Tuesday and Thursday at 10AM EST
In Part 1, we established that cancer was rare in antiquity. The bones don’t lie. The medical texts barely mention it. Cancer existed, but it lived on the margins of human experience, a curiosity, not a commonplace.
The question now: when did this change?
When did cancer transform from medical anomaly into the second leading cause of death in the developed world?
The transition has specific inflection points. Each one correlates with industrial toxins, urban density, dietary shifts that fundamentally altered human metabolic environments. This pattern isn’t gradual or abstract. It’s documented. Datable. Undeniable.
This is the story of when cancer became common.
The Chimney Sweeps: First Proof of Occupational Cancer (1775)
Picture a London surgeon in 1775, confronted with a pattern too consistent to ignore.
Boys. Young men. All chimney sweeps. All dying of scrotal cancer.
Percivall Pott made medical history by documenting what every sweep-master already knew but never said aloud: soot was killing them. The narrow chimneys of London’s coal-heated homes required small bodies to climb and scrape. Boys as young as four were sent up into darkness, their skin chronically exposed to combustion byproducts that lodged in every fold and crevice of their flesh.¹
The scrotum, with its thin skin and deep folds, became a trap for carcinogens. Polycyclic aromatic hydrocarbons from coal soot accumulated there, marinating tissue for years until malignancy erupted.
Pott’s discovery shattered three assumptions in a single blow.
First, cancer wasn’t just an internal constitutional weakness. External chemicals could cause it. Before Pott, physicians thought cancer arose from humoral imbalances or inherited predispositions. Pott proved that a specific substance (soot) could induce malignancy. This was the beginning of understanding cancer as an environmental disease.
Second: cancer wasn’t just a disease of old age. Pott documented scrotal tumors appearing in boys as young as eight. These children hadn’t lived long enough to accumulate a lifetime of cellular damage. High-dose toxin exposure accelerated carcinogenesis so dramatically that age became irrelevant.
Third: cancer could be prevented. If soot caused the disease, removing the exposure would stop it. Parliament passed the Chimney Sweepers Act of 1788, the first cancer prevention legislation in human history.² Enforcement was weak. The practice of using child sweeps continued for decades. But the principle was established: you could prevent cancer by removing carcinogens.
Pott’s chimney sweeps were a warning.
The intense exposure these children endured (combustion byproducts soaked into skin for hours each day) would soon become generalized across entire urban populations. Coal smog. Industrial pollution. Factory fumes. Eventually, cigarette smoke.
The Industrial Revolution wasn’t just transforming economies. It was transforming human biology.
The London Bills of Mortality: Watching Cancer Rise in Real Time
As the Industrial Revolution accelerated, statistical records began capturing the change.
The London Bills of Mortality were weekly death tallies compiled by parish clerks. Originally created to track plague outbreaks, by the 18th century they provided a crude but valuable snapshot of who died and why. In 1735, “Cancer” accounted for 58 deaths out of thousands recorded, roughly 0.25% of total mortality.³
Read that again. One quarter of one percent.
Today, cancer accounts for 25% to 30% of deaths in developed nations. That’s a hundred-fold increase, not a ten-fold one.
Even accounting for diagnostic limitations, even allowing for underreporting, the gap is staggering. These weren’t death certificates filed by trained oncologists. They were weekly logs of who died in each parish, compiled by clerks who noted obvious causes: fever, consumption, childbirth, old age, tumors.
Yes, internal cancers were undoubtedly missed: liver cancer recorded as “dropsy,” lung cancer as “consumption,” pancreatic cancer as “wasting.” But external tumors (breast, skin, facial, testicular) were visible, palpable, unmistakable. Even if we assume 90% of cancers went unrecorded, we’re still looking at a massive increase. And the bone evidence from Part 1 confirms it: cancer was genuinely rare, not just hidden.
By the mid-19th century, the pattern shifted. London’s population density exploded. Coal use skyrocketed. Mortality records changed. The “Mortality Revolution” saw deaths from infectious diseases decline as sanitation improved, water became cleaner, vaccines prevented epidemics. This unmasked chronic conditions that had been overshadowed by plagues and fevers.
By 1851, districts with heavy industrial employment showed distinct elevations in “tumors” and “wasting diseases.”⁴ The gradient was clear: cancer rose fastest in the most industrialized, urbanized zones.
This wasn’t better diagnosis. This was real increase.
The Bills of Mortality documented it in real time, parish by parish, year by year. Cancer was climbing.
Stanislas Tanchou: The Disease of Civilization Hypothesis (1840s)
French physician Stanislas Tanchou was a veteran of the Napoleonic wars who turned his attention to civilian medicine in the 1840s. He conducted statistical work in Paris that reached a stark, controversial conclusion:
Cancer incidence increased in direct proportion to the “civilization” of a population.⁵
Tanchou saw a gradient. Urban Paris had the highest rates. Rural France had lower ones. The “primitive” populations of Africa and the Americas described by European explorers and medical missionaries had virtually none.
He hypothesized that cancer was driven by the artificiality of modern life: sedentary habits, rich diets, indoor living, psychological stress. Something about urban, industrialized existence was driving malignancy.
In the 1830-1840 decade, cancer claimed 9,118 lives in the Paris region. Tanchou documented a gender disparity: 6,967 women versus 2,161 men.⁶ This reflected the clinical visibility of breast and uterine cancers, which were easier to diagnose than internal tumors hidden deep in the body. Women’s cancers announced themselves. Men’s cancers stayed silent until late stages.
Tanchou presented his findings to the Académie de Médecine. He argued that cancer wasn’t an inevitable consequence of aging, but a disease caused by modern living conditions.
The medical establishment dismissed him.
Critics said “primitive” populations simply died younger and therefore never lived long enough to develop cancer. Others claimed explorers and missionaries lacked diagnostic tools to recognize malignancy when they saw it.
These objections would be systematically refuted by 20th century ethnographic work. But in the 1840s, Tanchou’s hypothesis was filed away as speculative.
History would prove him right. It would take a century.
The Gradient: Urban, Rural, Primitive
Tanchou’s most important contribution wasn’t his numbers. It was the gradient he identified.
Cancer prevalence wasn’t random. It followed a pattern:
Highest in cities. Lower in the countryside. Lowest in populations living under pre-industrial conditions.
This gradient suggested that something about industrial urban life was driving cancer. The variables were numerous: coal-combustion air pollution, occupational chemical exposures, dietary changes (more sugar, refined flour, preserved foods), sedentary work, indoor confinement, psychological stress.
By the late 19th century, other researchers began confirming Tanchou’s observations. Rudolf Virchow, the father of cellular pathology, noted in the 1860s that urban cancer rates exceeded rural ones.⁷ British physicians treating colonial populations in India and Africa consistently reported that cancer was rare among indigenous people living traditional lifestyles, but more common among those who adopted European habits.
The pattern held across continents: the more “civilized” (urbanized, industrialized, Westernized) a population became, the more cancer appeared.
By the early 20th century, this observation was no longer controversial. It was documented repeatedly by medical missionaries, frontier doctors, anthropologists working with indigenous populations. What remained unclear was mechanism. What specific factors were driving the increase?
The Dismissal and the Vindication
Tanchou’s “disease of civilization” hypothesis was dismissed by mainstream medicine for over a century. The dominant narrative remained: cancer was primarily genetic, a consequence of aging, or simply better diagnosed in modern populations.
But the ethnographic record between 1900 and 1960 provided something unprecedented: a natural experiment.
Western medicine was advanced enough to diagnose cancer with reasonable accuracy. Yet large populations still lived under pre-industrial conditions. Medical missionaries and explorers working with these groups consistently reported the same finding:
Cancer was virtually absent in populations adhering to traditional diets and lifestyles.
Albert Schweitzer, upon arriving in Gabon in 1913, found no cancer among the indigenous population. When the first cases appeared years later, they were exclusively in locals living near white settlements, eating imported flour and sugar.⁸ Vilhjalmur Stefansson documented cancer-free Inuit eating pure animal fat. Robert McCarrison’s Hunza thrived on whole foods. Weston A. Price’s global survey found the pattern held everywhere.
When traditional populations adopted Western diets and lifestyles, cancer rates climbed to Western levels within a generation.
The gradient Tanchou observed in 1840s Paris wasn’t an artifact of poor diagnosis. It was a biological signal. Cancer was, and is, a disease of civilization.
The specific mechanisms wouldn’t be understood until the late 20th and early 21st centuries: refined sugar’s metabolic disruption, industrial seed oils’ inflammatory cascade, circadian dysregulation’s hormonal chaos, mitochondrial dysfunction’s energy crisis. But the epidemiological reality was established by the mid-20th century:
Cancer exploded in direct correlation with industrialization.
Tanchou’s hypothesis was dismissed in his lifetime. The ethnographic record vindicated him posthumously.
The Inflection Point
The historical evidence reveals a sharp break.
Cancer was rare in antiquity (less than 0.5% of deaths). It began rising in the 18th century with industrialization. By the mid-19th century, it climbed visibly in urban centers. By the mid-20th century, it had become epidemic, accounting for 20% to 30% of mortality in industrialized nations.
This is not a gradual, linear increase over millennia. It’s a sharp, exponential rise over two centuries.
The “better diagnosis” argument collapses under scrutiny. Better diagnosis explains why we find more cancer. It doesn’t explain why so many more people die from it. The London Bills of Mortality tracked deaths, not diagnoses. When cancer mortality rises from 0.25% to 30% of all deaths (even adjusting for age) that’s not better detection. That’s an epidemic.
The “longer lifespan” argument fares no better. Here’s the fact that destroys the #1 defense of modern oncology: Life expectancy at age 60 didn’t increase dramatically until the late 20th century. Ancient Egyptians, Greeks, Romans who survived childhood regularly lived into their 60s and 70s. If you made it to adulthood in ancient Rome, you had roughly the same lifespan as someone in 1950s America.
Medieval skeletons show cancer prevalence at death of 3.5% to 4.7%. Modern Britain: 40% to 50%.⁹
That’s a ten-fold difference that age alone cannot explain.
The inflection point was not demographic. It was environmental.
Something about industrial civilization fundamentally altered the human metabolic environment, creating conditions where cancer transformed from rare curiosity into leading cause of death.
Conclusion: The Pattern Is Undeniable
Percivall Pott’s chimney sweeps proved external chemicals cause cancer. The London Bills of Mortality documented cancer’s rise from 0.25% to over 25% of deaths. Stanislas Tanchou identified the civilization gradient: highest in cities, lower in rural areas, virtually absent in traditional populations.
The pattern is undeniable. Cancer exploded in direct correlation with industrialization.
What Comes Next
The inflection point is documented. Cancer exploded with industrialization. But what specific changes drove it?
In Part 3, we’ll meet the witnesses who watched it happen in real time. Albert Schweitzer arriving in Gabon to find cancer absent, then watching it appear as European food arrived. Vilhjalmur Stefansson documenting Inuit thriving on 80% fat, then deteriorating with flour and sugar. Robert McCarrison’s rats testifying in blood: traditional food equals health, Western food equals tumors. The ethnographic evidence will complete the case that cancer is a disease of civilization.
The historical record documents when cancer became epidemic. The witnesses document how.
This is Part 2 of a 6-part investigative series on cancer as a disease of civilization. Part 3 will present ethnographic evidence from traditional populations and the witnesses who documented cancer’s arrival.
Disclaimer: This article presents historical analysis and epidemiological evidence. It is not medical advice. Individual treatment decisions should be made in consultation with qualified healthcare providers. The historical case studies referenced are documented in peer-reviewed literature and historical medical records.
Footnotes
* Percivall Pott’s 1775 discovery of scrotal cancer in chimney sweeps - Pott, Percivall. “Chirurgical Observations Relative to the Cataract, the Polypus of the Nose, the Cancer of the Scrotum, the Different Kinds of Ruptures, and the Mortification of the Toes and Feet.” (1775). This was the first documented case of occupational cancer, establishing that environmental carcinogens (soot containing polycyclic aromatic hydrocarbons) could induce malignancy. Pott’s work demonstrated that cancer was not purely constitutional but could be caused by external exposures. https://pubmed.ncbi.nlm.nih.gov/20803222/
* Chimney Sweepers Act of 1788 - British Parliament passed this act to regulate the use of child chimney sweeps following Pott’s discovery, marking the first legislative attempt at cancer prevention. Enforcement was weak, but the principle of preventing occupational carcinogen exposure was established. https://www.historyofparliamentonline.org/volume/1790-1820/member/wilberforce-william-1759-1833
* London Bills of Mortality (1735) - Weekly mortality records compiled by parish clerks showed “Cancer” accounting for approximately 58 deaths out of thousands recorded, roughly 0.25% of total mortality, orders of magnitude lower than modern rates of 25-30%. These records provide direct evidence that cancer was genuinely rare in pre-industrial populations, not merely underdiagnosed. http://www.thornber.net/medicine/html/1735.html
* Industrialization and mortality patterns in 19th century England - Beach, Brian, and W. Walker Hanlon. “Coal Smoke and Mortality in an Early Industrial Economy.” The Economic Journal 128.615 (2018): 2652-2675. This study documents elevated mortality rates in industrialized districts by the mid-19th century, showing distinct health impacts of coal pollution and industrial work. https://www.nber.org/papers/w19693
* Stanislas Tanchou’s “disease of civilization” hypothesis (1840s) - Tanchou presented statistical work to the Académie de Médecine in Paris demonstrating that cancer incidence increased with “civilization.” He observed cancer was most common in urban centers, less common in rural areas, and virtually absent in traditional populations. His work was dismissed but later vindicated by ethnographic studies. https://dokumen.pub/cancer-disease-of-civilization-an-anthropological-and-historical-study.html
* Cancer mortality statistics in 1830-1840s Paris - Tanchou’s data showed 9,118 cancer deaths in the Paris region during the 1830-1840 decade, with a significant gender disparity (6,967 women vs. 2,161 men) reflecting the visibility of breast and uterine cancers. These statistics were among the first systematic cancer mortality records. Darby, Michael. “Gender and Cancer in England, 1860-1948.” Social History of Medicine (2007).
* Rudolf Virchow on urban-rural cancer gradient - Virchow, Rudolf. Die Cellularpathologie in ihrer Begründung auf physiologische und pathologische Gewebelehre (Cellular Pathology). (1858). Virchow, the founder of cellular pathology, observed that cancer rates were higher in urban areas than rural ones, supporting Tanchou’s civilization hypothesis with pathological evidence.
* Ethnographic confirmation of the civilization gradient - Multiple 20th century medical observers documented cancer’s rarity in traditional populations and its emergence upon Westernization. Key sources include: Schweitzer, Albert. On the Edge of the Primeval Forest (1922); Stefansson, Vilhjalmur. Cancer: Disease of Civilization? (1960); McCarrison, Robert. Studies in Deficiency Disease (1921); Price, Weston A. Nutrition and Physical Degeneration (1939). These independent observations across continents confirmed Tanchou’s hypothesis.
* Medieval vs. modern cancer prevalence - Binder, Michaela, et al. “On the Antiquity of Cancer: Evidence for Metastatic Carcinoma in a Young Man from Ancient Nubia (c. 1200BC).” PLOS ONE 9.3 (2014). Medieval British skeletons show cancer prevalence at death of 3.5-4.7%, compared to 40-50% in modern Britain, a ten-fold increase that cannot be explained by age demographics alone, indicating a genuine environmental shift. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0090924
