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24 CANCER
Cancer: Malignant Disease
The deaths from the various malignant new growths numbered 156 in 1909 from which
figure the annual total increased to 211 in 1914 and then fell to 164 in 1918. In 1919 the total
increased to 170 and again in 19.20 to 194. The annual average of deaths during 1909-13 was
170 and that during 1914-18, 198. The average for the two years 1919 and 1920 was 182,
showing an increase of 7 per cent, above the average for 1909-13, and a decrease of 8 per cent,
below that for 1914-18. (See Table VIII. B, Appendix.)
In the absence of the data for calculating mortality rates, the following ratios of deaths
from "cancer" to total deaths all causes are submitted—
"cancer" Deaths.
Per cent, of all Deaths.
1909-13 9.7; 1914-18 9.5; 1919 8 8; 1920 113; 1919-20 10.0.
Inasmuch as it can be confidently stated that the total mortality rate has fallen during the
past two years—even below the mean rate for 1909-13—it is safe to conclude that there has
been a considerable increase in the mortality due to "cancer." Such statement does not of
necessity involve an increase in the prevalence of the disease because cancer being a disease of
late adult ages it follows that as the proportion of those ages increases an increased proportion
of deaths from "cancer ' must be expected.
Table XVII., Appendix, gives an analysis by form of "cancer," site of disease and sex-age
distribution of the deaths recorded during the two years. Comparing the numbers of deaths
certified as due to the various forms of "cancer" with the averages for 1909-13 and 1914-18, it
appears that deaths from carcinoma show a continuous increase since 1909-13, the movements
of the numbers under the other headings being irregular. The Index Numbers (averages
1909-13=100) for carcinoma are—Persons. 1914-18, 120; 1919-20, 130: Males, 1914-18, 112;
1919-20, 132 : Females, 1914-18, 126; 1919-20, 129.
The use of the terms "cancer" and "malignant disease" is objected to on account of their
indefiniteness. It is satisfactory, therefore, to be able to record a notable reduction in the
proportion of deaths classified under those heads during 1919-20. In 1909-13, deaths so
classified formed 25.1 per cent, of all "cancer" deaths, the proportion rising to 25.7 per cent,
during 1914-18 but falling to 16.7 during 1919-20.
The deaths from "cancer" of the digestive and generative systems form by far the greater
proportion of cancer deaths. In the three periods under review, the deaths from disease
located in the former system alone shows a continuous increase (see below).

Anthrax.
In July, 1915, a solicitor's clerk resident in the Borough died at the West London Hospital,,
the death being registered, after inquest, as due to anthrax cf which the evidence available did
not show the origin. From enquiries made suspicion fell on a new shaving brush. Parts of
the brush were examined bacteriologically but no baccilli or spores of anthrax were found.
Spores were, however, found in a brush obtained from the wholesale vendor of the suspected
brush. The local vendor's shop was visited and the remaining brushes wilh the incriminating
narks were destroyed.
The above incomplete case is recalled because in October, 1919, a case of anthrax was
reported to the Medical Officer of Health of Hammersmith, verified bacteriologically, and
traced to a shaving brush purchased in this Borough. Acting on the information received the
vendor's premises were visited and six specimen brushes were taken away and sent to the
Lister Institute. The bacillus anthracis was definitely demonstrated in two out of the six
brushes. The facts were reported to the Ministry of Health and to the Medical Officer of
Health of the City, within whose jurisdiction was located the wholesale vendor of the brushes.