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178 Report of the Medical Officer of Health.
but it increased in 1891-1900 to 75.8, and for London only in the
decennium 1851-1860 it was 42, and for 1891-1900 85, or slightly
more than double.
With regard to the increase in the mortality from Cancer
compared with the 10 years' average, an increase which from the
Report of the Registrar-General is more observable in London than
in England and Wales, the following extract from the RegistrarGeneral's
Report for 1911 is worthy of special notice:—
"While the figures for a single year would be far too small
a basis for forming a definite conclusion on this matter, and
there is evidence pointing to a real increase of Cancer of certain
parts of the body, the figures for 1911 seem to harmonise
sufficiently with the hypothesis that recorded differences in
mortality depend upon varying degrees of accuracy in diagnosis
to make it worth while to watch those of subsequent years
from the same point of view. If the latter point in the same
direction then we must ask ourselves whether England and
Wales in 1911 does not compare with England and Wales
in 1881 more or less as London in 1911 does with the rural
districts in 1911. The peculiar history of the increase of
Cancer mortality in regard to age and sex would then be
explained. The records show continuous increase at all ages
for males, whereas in females the increase at ages 35-45 ceased
about 20 years ago, and more recently that at 45-55. At the
later age-periods the increase still continues at rates which
increase in rapidity with increase of age. The male increase
at all ages would be explained by the fact that, taking the
country as a whole, there is still considerable room for improvement
in diagnosis at every age in males. The cessation of
increase in middle-aged women is explained if we assume that
Cancer is being better diagnosed in the female sex and at the
earlier ages is now seldom overlooked in middle-aged females
than it formerly was so, the frequency of occurrence being
assumed constant. Probably there is little doubt that Cancer
is more easily diagnosed, because more accessible, in females,
but the assumption that it is more frequently overlooked in
old than in middle age is more open to question."