On the alleged Increase of Cancer. 

 Table E. 



225 



Of the cancers enumerated above, cancer of the pharynx, thyroid 

 gland, larynx, trachea, and penis are most accessible, but their number 

 is so small (twelve in all) that their transference to the "accessible" 

 group would have no appreciable effect; and since, before the paper 

 took its present shape, they had been included with other cancers in 

 their appropriate physiological system, and a considerable amount of 

 calculation had been based upon that classification, they have been 

 allowed to remain in the " inaccessible " group. 



Cancer of the prostate and bladder may be regarded as intermediate 

 between the " accessible " and " inaccessible " groups, but as cancer 

 of these organs appears to have increased in a smaller proportion than 

 the population, the effect of introducing it into the " inaccessible " group 

 is rather to diminish the already striking difference which we shall 

 show to exist between the increase in " accessible " and " inaccessible " 

 cancer respectively. 



Cancer of the oesophagus has, we think, been properly placed in 

 the "inaccessible" group. The majority of cases of stricture of the 

 oesophagus in persons over 50 are undoubtedly due to cancer, and 

 yet certificates stating the cause of death at these ages as " stricture 

 of oesophagus," without any definition of the cause of stricture, are 

 still common. There can be no doubt that in the past they have been 

 much more common, and that therefore cancer of the oesophagus is 

 rightly placed in the class of " inaccessible " cancers which have been 

 largely affected by improved diagnosis and certification of deaths. 



Cancer of bone has also been placed in the same group. The 

 number under this head is small, and, as the vertebras and other 

 inaccessible bones are a favourite seat of cancer of bone, the classifi- 

 cation appears to us correct. 



Cancer of the rectum is more accessible than that of other parts of 



