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20
CANCER.
instances the duration was under 12 months, in 18 between one and two years, in 29 between two and
five, in 11 between five and 8, and in 3 over eight.
Completeness of Notification.—Of the 127 deaths assigned to the Borough, 6 took place before the
notification certificates were received, 15 within one month of notification, and 15 between 1 and 3
months. With respect to 23 deaths no notifications were received by the Medical Officer of Health
of the Borough. Of those 23 deaths 6 took place in the deceased persons' homes, 10 in local institutions
and 7 in out-lying. The 6 deaths in the patients' homes included 2 from pulmonary disease, one
being an inquest case (the disease was unsuspected during the deceased's life), and in the other instance
the practitioner certifying the death thought that another practitioner had notified the case. The
4 other cases included 3 meningeal and 1 "gland" cases. The last ought, undoubtedly to have been
notified as there had been an operation for tuberculous glands in 1920.
The 10 deaths in local institutions included 7 of pulmonary and 3 of other forms of the disease.
In 9 instances it was stated that the diagnosis was made at post-mortem examination only—in the
majority of the instances the duration of treatment at the institution had been very short—and in the
remaining instance death ensued within a few hours of admission.
The 7 non-notified deaths in out-lying districts included one in prison (cases in prisoners are not
notifiable), 2 which had been notified in the districts where the deaths took place, one an inquest
case, another diagnosed at post-mortem examination only, and 2 not satisfactorily explained.
The 23 non-notified deaths were equal to 18.1 per cent. of all deaths from tuberculosis as compared
with a mean percentage of 22.6 during 1918-22. On the whole the reasons for absence of notification
to the Medical Officer of Health of the Borough were more acceptable last year than in previous years.
Survivors.—The Department began to keep records of cases—as distinct from deaths of tuberculosis
in 1903, in which year 4 cases were reported. At the end of 1908 356 cases had come to the
knowledge of the Department, but the records were recognised as being very incomplete. Notification
was inaugurated at the commencement of 1909, and the Paddington Dispensary was opened at the
same date. Since then the Department has had much more complete information of all cases of the
disease. During the 21 years 7,370 cases of diagnosed tuberculosis (all forms) have been placed on the
Register and (since January, 1909) 2,633 "suspect" cases. Of the total 10,003 cases 1,731 have been
taken off the Register on account of change of diagnosis, and 27 "suspect" cases have been transferred
to the "definite" group. Of the 7,370 "definite" cases 760 have been marked "arrested." Removals
numbered 3,360 during the whole period, but 85 patients were subsequently restored to the Register.
The deaths among the persons on the Register which have come to the knowledge of the Department
numbered 2,332.
At the end of 1922 there were 1,743 names of persons certified as having tuberculosis, and 51 of
those reported as suspected to have the disease. At the end of 1923 the entries comprised 1,850 for
certified cases—1,186 with pulmonary disease, 664 with other forms—and 28 for suspect cases—
equally divided between pulmonary and other forms. Five cases of definite pulmonary disease
placed on the Register before 1909 are included among the survivors at the end of 1923.
CANCER: MALIGNANT DISEASE.
(See Tables 6, 7 and 12.)
The deaths from the malignant neoplasmata numbered 206, 80 in males and 126 in females. In 1922
these deaths numbered 191—93 of males and 98 of females, the figures for 1921 being—Persons, 226;
males, 93; females, 133. The annual average (persons) for 1918-22 was 189, the total for last year
being 9 per cent. in excess of that average. The statement given below shows the number of deaths
last year in each Ward and the annual averages for the preceding quinquennium. It will be noted that
last year's numbers were higher in each of the Wards except Westbourne and Lancaster Gate, West,
the reduction in each case being 14 per cent. of the average. In the other Wards the increase varied
from 6 per cent. (Harrow Road) to 50 (Hyde Park).

* Annual Averages.