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67
cancer.
In the course of the calculations of the standardising factors the standard number of
deaths—i.e., the number of deaths which were to be expected if the standard sex-age mortality
rates had prevailed—was obtained for each Ward. A comparison of those numbers with the
numbers actually recorded has been thought to be of some interest. As a general rule the recorded
numbers are higher than the standard. In the case of Westbourne Ward the observed excess
is somewhat remarkable, as the standard numbers have been obtained by the use of the census
population, and that population is artificially " old " in that Ward by reason of the inclusion
therein of the aged inmates of the Workhouse and Infirmary. In the three southern Wards the
position is reversed, as the average age of the populations of those wards is lowered by the
inclusion therein of relatively large proportions of servants of young adult ages. The whole
subject of high mortality from cancer in the Borough is well worth close study, and now that the
Department has data for more than twenty years, it is hoped that time may be found for taking
the subject into consideration.

In the meantime the figures shown below indicate the extent to which cancer as a certified
cause of death has increased since 1901. As already stated when writing on tuberculosis, the
changes in the enumerated population of the Borough have been so slight as to make the calculation
of mortality rates scarcely necessary for the present purpose. The number of deaths (persons)
recorded annually was 149 during the four years 1901-4, increased to 168 in the following four
years, then fell to 166, and was 185 last year. The index numbers show that the growth was
12 per cent. in the second period, 11 per cent. in the third, and 24 per cent. last year. Allowances
must be made in comparing the record of one year with the averages for series of years, but
there can be no room for doubt that there has been a substantial increase in the annual number
of deaths due to this cause. The index numbers for the separate sexes suggest (even with all
reservations) that the increase has been greater in the case of males than in that of females.

Institutional Treatment.—Of the 185 deaths recorded last year, 85 occurred in institutions
of various descriptions, equal to 43.8 per cent of the total. The deaths in Poor Law institutions
numbered 38, in hospitals 37 (including 18 in Middlesex Hospital), the remainder in nursing
homes, "homes of rest," &c. There has been a considerable increase during the past thirteen
years in the proportion of deaths in institutions, as appears from the figures given below. The