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26
From the preceding table it can be seen that the age group
45 to 65 years is still the period of greatest mortality and is more
than twice that of the next age group, viz : 65 to 75 years, a category
in which the reverse would have been a more normal pattern.
In 1947, there were 25 deaths of Greenwich residents from
cancer of the lung, approximately one third of the total registered
for pulmonary tuberculosis, viz : 69. During the current year,
figures of 46 and 7 respectively have been recorded showing that
lung cancer is now claiming nearly 7 times as many victims as
pulmonary tuberculosis. In comparison with the Borough rate of
0.52 for lung cancer, that for London as a whole is 0.61 and for
England and Wales 0.43.
Nationally as well as locally, recent years have shown an exceptionally
rapid decline in the death rate of pulmonary tuberculosis
whereas that for cancer of the lung has increased, one might almost
say, correspondingly.
In this connection, facts presented by the Medical Research
Council emphasize the hazard to life occasioned by the smoking
habit but unfortunately, smoking is a personal habit not known to
involve risk to non-smokers and therefore the usual approach on
epidemiological grounds for its elimination can hardly be justified.
It is clear, however, that Health Authorities have a real part to play
in the dissemination of information in such a way as, on the one
hand, to be easily understood by the layman and on the other, not
to increase apprehension or alarm or to produce hypochondriasis.
It seems logical that education in these matters should commence
with the young in first preventing the adoption of the
' smoking ' habit and then to persuade the moderates and unaddicted
to refrain. The hard core of heavy smokers however, presents a
much more formidable obstacle and it is difficult to know what
practical steps can be taken to break this pernicious habit other
than a reasoned statement of the true facts, to counteract the enormous
amount of propaganda met with in modern advertisements.
Consideration has been given at various times to the question
of making malignant diseases notifiable, as in present circumstances
the only information available to a Medical Officer of Health is that
obtained from the death returns; he therefore gains no knowledge
of the incidence of the disease, effect of treatment, recovery rates
or possible pre-disposing factors. So far, no such scheme for notification
has yet been formulated.