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60
From his findings it would appear that the heavy drinker drinks
because he likes it whereas the alcoholic drinks because he needs it.
Whatever the fundamental cause of this distressing and socially
stigmatising complaint we ought to recognise that such a problem
does exist and make some positive efforts towards its solution.
Cancer
Since more people are reaching the older age groups, it is
perhaps only to be expected that, in existing conditions, death
rates from cancer would rise—but slowly. Although generally
this seems to be the case, with assistance from modern chemotherapy,
radiotherapy and surgery, some rates have been stabilised
and others even reduced. Lung cancer is the notable exception.
During 1969, over 10% of all male deaths arose from cancer of the
lung which has persistently shown an annual increase of 3.5%
over the last 15 years. This is all the more discouraging because
the greater part of the problem is man-made and preventable.
Early in this century the death rate from lung cancer, which
tended to be similar in both sexes, was low and remained so
until the 1930s at which time a steady advance, especially among
males, became discernible. At first, this was attributed to improved
diagnosis but an accelerating increase, apparent from 1940 and
continuing to the present day, shows this explanation to be largely
fallacious.
In 1940, the highest incidence of lung cancer was recorded in
males 55/65 years of age—those who, as young soldiers in the
first World War, adopted the new tobacco habit and became the
first group of "all-life" cigarette smokers. As this group ages
so the peak incidence moves up correspondingly until eventually,
we fervently hope, it will level out.
Lung cancer in females is only one fifth of that of males but
cigarette smoking in women is increasing rapidly and their mortality
from this disease has now reached the proportions attained by men
in 1940. If present trends continue it would not be unduly
pessimistic to predict a repeat of the male pattern and the
emergence in 20 years time of a female lung cancer rate akin to
that attending males today.
In urban areas atmospheric pollution undoubtedly plays its
part in the rising rate of lung cancer but it cannot be of major
importance, else why the differential ratio of 5:1 between males and
females and furthermore, despite active operation of the Clean
Air Act, these rates continue to rise. Indeed, the highest lung
cancer rates are to be found in the Channel Islands where the air
is pure but cigarette consumption is excessive.