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Getting a global view on cancer

When Dartmouth internist H. Gilbert Welch, M.D., M.P.H., was offered a 10-month sabbatical as a visiting scientist in Lyon, France—at the World Health Organization's (WHO) International Agency for Research on Cancer (IARC)—he leapt at the chance.

He returned to the Upper Valley a few months ago, having had a productive stay working on, among other projects, the manuscript for a book titled Should I Be Tested for Cancer? Scheduled to be published in 2003 and written for a general audience, it "walks readers through the downside of cancer testing," he explains, including unnecessary treatments.

During his sabbatical, Welch also helped the IARC's director write a book chapter, worked on two articles for the Journal of the National Cancer Institute (see the adjacent story for details on one of them), and served as a member of the WHO's Working Group on Breast Cancer Screening, which recently concluded that women over 50 years old do benefit from breastcancer screening mammograms.

And by interacting with the international scientific community, he developed a greater appreciation for such issues as the variation in interpreting mammography from country to country. "In Europe, radiologists are less likely to say a mammogram is abnormal" than in the United States, he says.

Welch also relished the chance to live abroad with his family— wife Linda Doss and teenage daughter Heather. It was his first experience with city living as well, since he grew up in Boulder, Colo., and now lives in the rural community of Thetford, Vt. In Lyon—France's third-largest city, with an urbanarea population of over a million—they even got along without a car, since public transportation is so good.

Welch admits that he struggled with speaking French, even though he took classes offered by the IARC. Luckily, "the language of science is English," he says. "The typical IARC meeting would start with a little bit of French . . . then break into English. The people at work spoke wonderful English."

But he says he learned enough French to "order beer, order a cup of coffee, and even attempt to give directions."


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