On changes in the recorded mortality from cancer and their possible interpretation / by Major Greenwood, jun., and Frances Wood.

  • Major Greenwood
Date:
1914
Catalogue details

Licence: In copyright

Credit: On changes in the recorded mortality from cancer and their possible interpretation / by Major Greenwood, jun., and Frances Wood. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    In various issues of the Eegistrar-General’s Annual Eeports during the eighties doubts were expressed as to how far the recorded increase of cancer mortality could be regarded as evidence of a real extension of the disease—e.g., in the forty-fifth and forty-sixth Annual Reports— but, so far as we know, the first writers to publish a detailed study of the matter were Mr. King and Dr. Newsholme, whose paper appeared in 1893. In the first part of that paper a comparison was instituted between the course of cancer mortality from 1860 to 1890 in England, Scotland, Ireland (males and females separated in each case) and the experience of the Scottish Widows’ Fund.^ Standardized rates were computed and curves applied by Mr. King’s modification of Milne’s graphic process. The characteristics of the resulting curves were as follows : The Irish males and females exhibit the lowest rates, which run approximately parallel and are not widely separated vertically. The English curves are far apart and show an increase in gradient with time, especially perhaps that of the males. The Scottish curves are- similar but the vertical distance between them is much less than in the last mentioned case. The Scottish Widows’ Fund curve (which we suppose refers almost entirely to male lives) corresponds in absolute height above the axis to the Scottish males, but its gradient, although positive, is decidedly less steep. The authors attributed the low rates for Ireland to poor diagnosis, the easier gradient of the Scottish Widows’ Fund to a higher level of skill among the medical men attending persons of the insured class and the nearer approximation of male and female rates in Scotland as compared with England to better education of the general practitioner in the former country. In the concluding part of the paper the experience of Erankfurt-on-Main is described, a city in which cancer deaths had long been classified in accordance with the part of the body primarily affected. The sites were divided into accessible and inaccessible, rates of mortality were formed and the results compared. The authors concluded that the “ one result of surpassing importance to be derived from them is that in those parts of the body in tvhich cancer is easily accessible and detected there has bee?i no increase in the mortality from it behoeen 1860 and, 1889.” This paper was adversely criticized by W. Roger Williams, who objected to some details of the classification of sites and quoted in ' It must be remarked that the total number of deaths recorded in the last-mentioned experience was only 545, while the smallest number in any single septennial period of the other series was 2,501. In common with other observers we have found it necessary to be very cautious in the use of rates unless deduced from very large total numbers of observations.