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some three times greater than those in rural areas but the rate for
smokers anywhere is still up to ten times that of non-smokers.
Bronchial exfoliative cytology for adult males could possibly be the
next step in the campaign against lung cancer.
Present emphasis on cervical cytology, besides being a sound
preventive measure, tends to counter what could well be a serious
worry to the middle-aged woman, namely, cervical cancer. Carcinoma
of the cervix, which is almost unknown in nuns, is rarer in single
women than in married and it is unusual in Jewish women, perhaps
because of the cult of circumcision in their males. There is, moreover,
statistical evidence that cervical cancer is less prevalent where an
obstructive contraceptive is habitually used. However, despite the
concentration on cervical cytology, logically there is more reason
for screening appropriate groups of women for the detection of
breast cancer, for deaths from this cause are more than four times
those for carcinoma of the cervix. Mammography, a method of soft
tissue X-ray, is by no means a new diagnostic aid but it is still the
commonly accepted technique for the examination of the breast for
cancer. Although not infallible, if used in combination with a
thorough clinical examination it gives a high degree of accuracy,
for each method tends to compensate for the false findings of the
other.
Radiological risks have already been recognised but these must
be intelligently equated with the many benefits accruing from the
information gained such as more accurate diagnoses, effective
treatment, relief of anxiety and the prolongation of life.
Uncertainty about cancer and its causes prompted the outlining
at length in my previous report of the various schools of thought
concerning the causation of cancer and the avenues now being
explored by modern researchers. Still more recent research suggests
that the vital lead which is proving to be so elusive could possibly be
found in the more effective use and better interpretation of existing
epidemiological data.
Investigations into 'graft' rejections have focused attention on
the relationship between 'cellular' and 'humoral' immunity. 'Cellular'
immunity, which is the body's method of immediately localizing
antigens (analagous to graft rejection), is a preliminary to the
development of'humoral' immunity, the synthesis of antibody which
renders bacteria more susceptible to phagocytosis. These two
processes have always been considered complementary.
It is now postulated that all attempts at immunizing patients
against cancer have proved to be abortive because, far from being
complementary, there is increasing evidence that these defence
mechanisms may well be antagonistic. The hypothesis is that
cellular immunity causes graft rejection but that antibodies against