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* The C.M.I, expresses the mortality of each year as a percentage of that of 1938 after adjustment for age difference in
the population's exposure to risk and for changes in cause assignment from 1940 onwards.
It will be noticed that crude figures for the country as a whole would have
suggested a war-time rise in cancer mortality of 37 per cent. for males and 7 per cent.
for females, though the risk, measured by a more exact method, was in comparison
almost stationary—a very small rise in males and a small fall in females.
The difference between the crude and standardised rates for London, which lost
a large proportion of its population (more young than old) by evacuation would
doubtless be larger but " standardisation " in London cannot be carried out until
age-group population estimates are once more available.
With regard to the long term trend, this is summarised for England and Wales
as a whole, in the last published Statistical Review (1940-45) by the RegistrarGeneral
as follows :—
"The combined effect of the various trends in different groups summed up
in the C.M.I, for both sexes, was that the index rose from 0.853 in 1901-10 to
0.983 in 1921-30 and 0.999 in 1931-35 and then decreased to 0.998 in 1936-40
and 0-988 in 1941-45. On the whole, therefore, cancer mortality has now turned
downwards, but amongst children, and males between 35 and 55, it appears to
be still increasing."
Up to 1948 the comparative mortality index for females has fallen to 0.911
(1938 = 1.000) while the male index has risen to 1.057.
For both sexes combined the long-term trend of cancer mortality in London can
be seen from Table 3 (p. 116). The increase there shown between 1891 and 1940 is
partly due to the increasing age of the population, partly due to improved diagnosis.
Mortality from cancer is higher in London than in England and Wales as a whole
particularly for men, as the following specimen figures show:—

The important changes in mortality in London between 1931-33 and 1946-48
in relation to certain specific sites are summarised on page 10:—