1893.] 



On the alleged Increase of Cancer. 



405 



III. " On the alleged Increase of Cancer." By George King, 

 F.I.A., F.F.A., and Arthur Newsholme, M.D., M.R.C.P. 

 Communicated by Dr. J. S. Bristowe, F.R.S. Received 

 February 27, 1893. 



(Abstract.) 



Attention is first drawn to the alarming increase in mortality from 

 cancer, shown by the Registrar- General's figures, and to the fact that 

 the view that this increase is due to more accurate diagnosis and 

 certification has been partially abandoned. 



An attempt is then made to test this conclusion, by a study from 

 an independent standpoint of the official cancer death-rates for 

 England and Wales, Scotland, and Ireland ; and by a comparison of 

 these death-rates with other data obtained from the experience of the 

 Scottish Widows' Fund Life Assurance Society, and from the official 

 cancer returns for the city of Frankfort-on-the-Main. 



In order to make the figures from these different sources exactly 

 comparable, corrections have been made for variations in age and 

 sex distribution. A standard population is taken (that of the 

 "English Life Table, No. 3. Persons.") The death-rates at the 

 different age-groups in each case are then multiplied into the popula- 

 tions at the corresponding age-groups in the standard population 

 assumed as a common basis. Thus we obtain in each case the total 

 deaths from cancer per annum among a million persons aged 25 and 

 upwards, grouped as in the standard population,. and can contrast the 

 different totals obtained, without any fallacy arising from varying age 

 and sex distribution of population. 



The results obtained are grouped in septennial periods, as the figures 

 relating to the Scottish Widows' Fund Assurance Society were only 

 obtainable in septennial periods. From these septennial results, the 

 corresponding death-rates are obtained for each single year by an 

 application of the graphic method employed by Milne in the con- 

 struction of his Carlisle Life Table. These are shown as a series of 

 curves. 



The Irish curves are the lowest, probably because medical attend- 

 ance in Ireland owing to poverty is on the average more meagre than 

 in Great Britain. The English curves for males and females are very 

 far apart. The Scottish curves for the two sexes are nearer together 

 than the English, the apparent cancer mortality in Scotland for males 

 being higher and for females lower than in England. The greater 

 propinquity of the Scotch male and female curves may be ascribed to 

 more correct diagnosis and certification in Scotland than in England. 

 This view does not, however, explain why the female English is 



