London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Lewisham 1957
[Report of the Medical Officer of Health for Lewisham Borough]
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extent accentuated by the actual rate of change of the figures, both of
incidence and mortality; in other words, when the figures ceased to be
stable and began dropping away then the difference in rate became
more marked, and will close up again when the figures are again stabilised.
In lung cancer there has always been a very marked sex difference,
the mortality usually being 6 to 10 times in males what it is in females.
This has been ascribed to the lesser amount of cigarette-tobacco smoked
by females (see table 13), the known large increase in smoking in the last
ten or fifteen years not yet having fully shown itself in lung cancer incidence
due to the very long latent period before lung cancer develops.
Consumption of cigarettes in the UK in representative years
Table 13
| Year | Adult males (lbs. per head) | Adult females (lbs. per head) | Ratio M :F (F= 1) |
|---|---|---|---|
| 1920 | 5.1 | ? | |
| 1924 | 4.6 | 23 | |
| 1928 | 5.6 | 0.3 | 19 |
| 1932 | 6.0 | 0.5 | 12 |
| 1936 | 7.1 | 0.8 | 9 |
| 1940 | 7.9 | 1.3 | 6 |
| 1944 | 9.0 | 2.5 | 3.6 |
| 1948 | 7.6 | 2.0 | 3.8 |
| 1952 | 7.7 | 2.5 | 3.1 |
| 1956 | 8.0 | 3.1 | 2.6 |
Even so it has been rather surprising that the large increase in
cigarette-tobacco consumption by women in the last twenty years has not
made the female rate close in more on the male rate. A complicating
factor here is that, although cigarette tobacco is looked upon as the main
precipitating cause in the vast majority of cases of lung cancer, it is also
thought that smoke in the atmosphere is an additional cause, and of course
males by and large are more exposed to smoke in the atmosphere
through working in the central parts of towns, or in smoky occupations,
than females.
These suggestions do not seem to account fully for the statistics and
it may be that there is some intrinsic difference in the way the lung
in females reacts to outside factors compared with the lung in males.
For lung cancer, 1957 showed a further increase in deaths—five
(to 101) in men, and nine (to 21) in women. The male to female ratio
last year was therefore about five to one.