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17
CANCER.
25.35 (17 per cent.). Comparison of single year's rates with means for a period are not satisfactory,
but it may be observed that the rates recorded in 1922 were above the means for 1920.22 at all ages,
except 5.15 and 45.55. Among females for 1910-12 the maximum rate (1.09) was recorded at ages
35.45, and the minimum (0.06) at ages 5.15. During 1920.22 the maximum (0.94) fell on the group
25.35 and the minimum (0.06) on the group 5.15. The rates were higher in the second period
at ages 15.25 (by 50 per cent.) and 25.35 (by 13) and 65 and over (9 per cent.). The reductions
noted at other ages varied from 59 per cent. in the group 35.45 to 41 per cent. in the group 0.5. In
1922 the rates in four of the age.groups were higher than the 1920.22 means, by amounts varying
from 54 per cent. (0.5) to 12 (45.55), and lower in the others, the falls varying from 100 per cent.
(5.15) to 8 (25.35).
As regards the rates of mortality from other forms of tuberculosis it will suffice to say that at the
ages 0.5 and 5.15—the age.groups of maximum incidence—the rates for 1920.22 are all lower than
those recorded during 1910.12, but it has to be noted that there were unexpected increases in some
of the higher age.groups. Last year's rates for the two youngest age.groups were below the means
among males, but among females there was an increase (of 50 per cent.) at ages 0.5.
Deaths in Institutions.—Of the 143 deaths from all forms of tuberculosis recorded last year, 84
(58.7 per cent.) took place in institutions, the mean for the years 1917.21 being 58.9 per cent. The
deaths of males in institutions formed 58.4 . of all deaths from tuberculosis in males, the
corresponding proportion for females being 59.9 per cent. Of the deaths due to pulmonary tuberculosis,
54.7 per cent. occurred in institutions during the past year, the average (1917.21) being 55.4,
while of those due to other forms of the disease the institutional deaths formed 76.9 per cent. in 1922,
the average being 74.3. While there has been but slight changes in the proportion of the institutional
deaths to all deaths, the distribution of deaths in the various classes of institutions has altered considerably.
Taking the deaths from pulmonary tuberculosis first: Last year 54.6 per cent. of the
deaths in institutions occurred in Poor Law Institutions, the average (1917.21) being 51.4; 14.0
. in the Hospitals of the Metropolitan Asylums Board set apart for tuberculosis, as compared
with an average of 7.3 per cent. ; and 12.5 per cent. in Lunatic Asylums, average 17.4. In the
case of other forms of the disease, the proportions were : Poor Law, 1922, 55 per cent., average 48.9;
General Hospitals, 1922, 20 per cent., average 33.8; Special Hospitals, 1922, 10, average 3.6. In
the other classes of institutions the changes (in both divisions of the disease) were insignificant.
Defects in Notification.—Of the 143 fatal cases recorded during the year, 24 were never notified
to the Medical Officer of Health during life, 9 of the deaths taking place at the deceased persons' homes
within the Borough, 10 in local institutions and 5 in out.lying districts (including institutions). In
12 instances the patients were dead when the notification certificates were received, and 21 patients
died within one month after notification.
CANCER: MALIGNANT DISEASE.
(See Tables VI., VII. and XII., Appendix.)
Last year 191 deaths—93 of males and 98 of females—were recorded, the mortality rates being,
persons 1.31, males 1.52, and females 1.16. The occurrence of a higher rate among males than
among females is unusual.
Last year's total was 35 below the figure (226) for 1921, 3 below that for 1920 (194), and 7 below
that for the annual average for 1914.18 (198). During 1910.12 the mortality rate (persons) was 1.17
per 1,000, and during 1920.22, 1.41—an increase of 20 per cent. During the periods mentioned the
rates among males were 1.20 and 1.48 (increase 23.3 per cent.), and those among females 1.17 and
1.36 (increase 16.2 per cent.).
The sex.age.group mortality rates have not been calculated, but it may be observed that last
year's figures when compared with the averages for the previous five years, show some unexpected
changes in the distribution of the deaths. In every age.group, except that of 65.75 (decrease 28 per
cent.) the numbers of deaths of males during the past year exceeded the respective average. Neglecting
the group 0.35 years, in which the deaths are so few as to be almost insignificant, it has been found
that the deaths at ages 45.55 last year exceeded the quinquennial average by 53 per cent., the increase
in the next group (55.65), amounting to 46 per cent. Approximate calculations indicate that in each
age.group, except that of 35.45, the mortality among males exceeded that among females.
Comparison of the numbers recorded in each Ward with the averages for 1917.21 shows that in
every Ward, except Harrow Road (no change), Lancaster Gate, West (fall of 25 per cent.), and Hyde
Park (no change) the deaths of males recorded in 1922 were in excess of the averages, the excess varying
from 77 per cent. (Westbourne) to 33 (Queen's Park). In the whole Borough the excess amounted
to 22 per cent. The deaths of females, on the other hand, were below the averages in the Borough
(by 15 per cent.), and in every Ward except Lancaster Gate, West (increase 55 per cent.), the deficiencies
varying from 67 per cent. (Queen's Park) to 10 (Westbourne).