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44
With improved diagnosis and more accurate certification and
as the proportion of elderly persons in the population grows, so
one expects the cancer rate to rise, but the increase since 1950, viz.
from a rate of 1.87 to 2.74, seems startling. Since that year, of
the sites mentioned above, only cancer of the stomach has remained
more or less static. That of the lung registers a 135% increase,
that of the breast 100%, that of the uterus 70% while cancer of
all other sites shows a 12% advance.
General.—In the past a great deal of difficulty and confusion
in the minds of the public has surrounded cancer because of the
numerous agencies concerned, viz, x-ray, cigarette smoking,
atmospheric pollution, cosmetics, cancer-producing hydro-carbons,
hormones, etc.
Cancer is a very ancient disease for evidence of it has been
found not only in the bones of cave men, but further back still in
antiquity, in the bones of the dinosaurs. Despite the fact that
cancer has been known for an inordinate length of time, it was not
until 1775 that Percival Pott established that skin cancer was often
a corollary of chimney sweeping and, today, it is universally recognised
that exposure to chemicals is an occupational hazard which
can lead to malignant disease.
Modern research suggests that in some cases there may be a
relationship between inherited chromosomal abnormality and
myeloid leukaemia, and in others that climatic conditions may be
indirectly responsible for the appearance of some strains of antigenically
similar viruses which have been recovered from the bone
marrow of patients suffering from various leukaemias, the connection
between which, so far, has only been postulated. There is also
abundant evidence that cancer of the womb is linked with poor
hygiene and clearly this must constitute a challenge to health
staffs generally and to health visitors in particular, both of whom
are pledged to regard health education as top priority. In this
connection, it would not come amiss to mention the Family
Planning Association and its invaluable work in the use, among a
number of its patients, of diagnostic cytology.
Many causes of cancer are still not known with any certainty,
although in the last decade there have been remarkable advances
in the recognition and understanding of the disease. It is generally
considered to be a disease of middle and old age, although in more
recent times cases have begun to appear in younger age groups and,
moreover, it is a disease which is rapidly becoming a serious
impediment to a healthy nation.
It is undeniable that fear is a very potent influence in
discouraging people from seeking medical advice but if there is