On the alleged Increase of Cancer. 



and of one death from the third to the second septennium. Where 

 the data are so scanty such slight adjustments are unavoid- 

 able. It may be added, however, that the general deductions to be 

 drawn from the forms of the curves are the same whether we 

 adopt the original or the corrected curve of the Scottish Widows' 



nd. 



In Table XII the distributed rates of mortality, as derived from 

 the curves, are given for each of the seven sets of observations so far 

 considered. 



We are now in a position to examine more attentively the nature 

 of the seven curves, and to attempt to derive from them the lessons 

 which they are capable of conveying. 



The Irish curves are the lowest of all, and are consistent with each 

 other. In each of them there is a moderate upward gradient from 

 the beginning to the end of the observations. 



The English curves for males and females are far apart, the female 

 mortality from cancer being very heavy. The two curves are, how- 

 ever, consistent with each other. They both show a decided and 

 slightly increasing gradient from beginning to finish. 



The Scottish curves are much nearer each other than the English, 

 the males in Scotland having a higher apparent mortality from 

 cancer than in England, and the females having one lower. The 

 gradient in the Scottish curves is much the same as in the English, 

 except that for the last year or two the rise is more rapid. The 

 experience for the last period is for two years only in Scotland, while 

 for England and Ireland it extends over three years, and this may 

 account for the difference. Probably for this reason the curves at 

 the end are more to be depended on for England and Ireland than 

 for Scotland. 



The correction for age distribution which we have introduced 

 brings out the fact that Ireland seems to enjoy a great comparative 

 immunity from cancer. Probably deficient accuracy in diagnosis 

 and certification may account for much, if not all, of this difference. 

 Ireland is a poor country, the majority of whose inhabitants cannot 

 afford to pay much for medical attendance. The resulting deficient 

 medical attendance would tend to produce defective diagnosis, and 

 thus to lower the cancer curve. Probably also, owing to the poverty 

 of the patients and consequently of the medical attendants, the 

 average skill of the general practitioners over large tracts in Ireland 

 is less than in Scotland and England, and this again would lead to 

 defective diagnosis. 



It is probable that in Scotland the general practitioner has been in 

 the past better educated than in England, and this would cause the 

 curves for the sexes to approximate, because in the female, cancer 

 being more commonly accessible in position, is more easily diagnosed 



