Janet Elizabeth Lane-Claypon

A Forgotten Epidemiologic Pioneer

In 1959, Mantel and Haenszel published their classic paper on ”Statistical Aspects of the Analysis of Data from Retrospective Studies of Disease.“¹ The first sentence of their paper states ”The present-day controlled retrospective studies of cancer date from the Lane-Claypon paper on breast cancer published in 1926.“

So who was Lane-Claypon?

Janet Elizabeth Lane-Claypon was born into a wealthy English family in rural Lincolnshire in 1877. She entered University College, London, in 1899, receiving her Bachelor's degree with first-class honors in 1902, a DSc in physiology in 1905, and an MD in 1910.

She was the first woman ever to receive a research scholarship from the British Medical Society. Her doctoral research (on the developmental histology of the ovary and the hormonal control of lactation) was carried out in the laboratories of the renowned physiologist Ernest Starling. Her work was extensively cited in Marshall's 1910 textbook on The Physiology of Reproduction, the first textbook on this topic. In 1907, Lane-Claypon joined the staff of the Lister Institute of Preventive Medicine, where she researched the bacteriology and biochemistry of milk. In 1909, she received a Jenner Fellowship from the Institute to study maternal and child health programs in Europe. Her subsequent career involved epidemiologic research, educational administration, and advocacy for maternal and child welfare.

Her 1926 paper cited by Mantel and Haenszel was titled A Further Report on Cancer of the Breast, With Special Reference to Its Associated Antecedent Conditions.² This 135-page document described a study of 500 hospitalized cases and 500 controls. The methodology (including a detailed questionnaire) was meticulously described, and the data were exhaustively analyzed and interpreted using contingency tables and standard statistical procedures. Remarkably, the findings included most of the currently recognized risk factors for breast cancer.

Lane-Claypon published 3 books and 30 papers, 2 of which (besides the breast cancer report) might be considered classics. A 1912 paper assessed weight gain in infants fed boiled cows’ milk compared with human breast milk. The study used for the first time the historical cohort design, used Student t to analyze the data, and controlled for confounding. Her 1926 study of survival from breast cancer surgery took into account competing risks and used a life-table survival analysis.

Lane-Claypon married at the age of 52. Restrictions on the employment of married women forced her from the civil service, whereupon she terminated her professional activities and moved to the country. She lived quietly with her husband until her death in 1967 at the age of 90.

Figure: Janet Elizabeth Lane-Claypon