70 ox THE PREVALENCE OF CANCER IN AUSTRALASIA. 



more easily diagnosed because of its localisation on parts more 

 accessible to examination, while in males it makes its appear- 

 ance more frequently in internal organs that might escape 

 superficial observation. I do not believe that much weight can 

 be attached to this reasoning. While I am quite ready to admit 

 that malignant tumours of the internal organs may be over- 

 looked at the onset of the disease we must remember that We 

 have to deal here only with the deaths occasioned by it, and with 

 few exceptions it is difficult to mistake then the cause of death. 

 On the other hand there is no doubt that the progress of surgical 

 science in the last twenty years has given aid to a certain 

 number of cancer patients, and has diminished (by more 

 successful operation and by more accurate diagnosis of the early 

 stages with the aid of the microscope) the number of persons 

 eventually dying from it ; so that also from this standpoint the 

 increase in the death rate from cancer cannot be accounted for. 



Moreover, as the statistics of New South Wales show, the 

 increase in the death rate of cancer has in this province been 

 actually higher amongst females (18- 38) than amongst males 

 (10-24). 



The hereditary transmission of tumours, or of the tendency 

 to such, is a fact well established. In a certain proportion of 

 cases of cancer the family history of the patient shows that 

 either father or mother or other relatives had been affected by 

 carcinoma, or died of it. Now carcinoma is essentially a disease 

 that manifests itself in elderly persons. Take for instance 

 Queensland : Of 1000 persons that die between 25 and 35 years 

 of age, cancer is the cause of death in about five, while between 

 50 and 65 one-thirteenth of the deaths (seventy-five out of 1000) 

 are occasioned by it. Victoria furnishes still more striking 

 figures. Of the total number of cases of death from cancer 

 persons under 80 years of age furnished a contingent of only 

 3*7 per cent., while in the same space of thirty years between 

 45 and 75 the percentage was nearly 80 (79*6). Under these 

 circumstances it is clear that in the vast majority of cases cancer 

 manifests itself after marriage, so that any tendency to it will be 

 unconsciously propagated. Thus : "In the case of a disease such 

 as tubercular phthisis, which in a large proportion of cases mani- 

 fests itself before the age of marriage, there will be at any rate 



