London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Willesden 1925
[Report of the Medical Officer of Health for Willesden]
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Ill
Cancer Mortality in Willesden.—The Cancer mortality figures for Willesden residents (set out
in the tables below) shew the same tendency as those for the whole of England and Wales.
Table 1. —Mortality per Million Persons Living
| Year. | England and Wales. | Willesden. |
|---|---|---|
| *1911 | 992 | 675 |
| *1921 | 1,215 | 1,099 |
| 1924 | 1,297 | 1,250 |
| 1925 | (Not yet available) | 1,402 |
* Census years.
Table 2.—Willesden Residents—Cancer Deaths.
| Years. | All Ages | Classified as to Ages. | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 0-1 | 1-2 | 2-5 | 5-15 | 15-25 | 25-45 | 45-65 | 65 and over | |||||||||||||
| 1914 | 155 | — | — | — | 1 | — | 14 | 85 | 55 | |||||||||||
| 1915 | 169 | — | — | 1 | — . | 2 | 20 | 82 | 64 | |||||||||||
| 1916 | 174 | — | — | 1 | 1 | — | 19 | 81 | 72 | |||||||||||
| 1917 | 160 | — | 1 | — | — | — | 19 | 79 | 61 | |||||||||||
| 1918 | 171 | — | — | — | — | 2 | 18 | 88 | 63 | |||||||||||
| Classified as to Ages. | ||||||||||||||||||||
| 0-1 | 1-5 | 5-10 | 10-15 | 15-20 | 20-25 | 25-35 | 35-45 | 45-55 | 55-65 | 65-75 | 75-85 | 85 and over | ||||||||
| 1919 | 172 | — | — | — | — | 1 | — | 7 | 18 | 43 | 51 | 34 | 16 | 2 | ||||||
| 1920 | 176 | — | — | — | 1 | — | — | 4 | 17 | 38 | 45 | 47 | 21 | 3 | ||||||
| 1921 | 183 | — | — | _ | — | 1 | — | 5 | 13 | 45 | 48 | 49 | 19 | 3 | ||||||
| 1922 | 170 | — | — | — | — | 1 | 1 | 6 | 19 | 28 | 51 | 39 | 23 | 2 | ||||||
| 1923 | 199 | — | — | — | — | 1 | 1 | — | 18 | 47 | 56 | 52 | 21 | 3 | ||||||
| 1924 | 214 | 1 | — | — | — | — | — | 1 | 15 | 36 | 62 | 65 | 28 | 6 | ||||||
| 1925 | 241 | — | 2 | -— | — | 1 | 3 | 8 | 14 | 46 | 73 | 61 | 30 | 3 | ||||||
5. Prevention.—In the absence of any certain knowledge of the cause of Cancer, we are faced
with a whole host of supposed pre-disposing factors against which we are called upon to be on our
guard. Many, however, of these supposed factors are beyond our control, and in confining our
attention to the few which seem to have established some claim to our consideration, we may be
reassured by the statement of G. W. Crile that there is " scarcely an instance of a complete account
of a case of visible Cancer that does not give a clear pre-cancerous history—a history of chronic irritation,
ulcer, scar, hyperplasia, innocent tumour, or a combination of these factors."
The factors of proved importance may be considered under the following headings :—
(1) Pre-cancerous conditions.
(2) Local manifestations of other diseases, e.g., syphilis.
(3) Sources of chronic inflamation and irritation.
(1) Pre-cancerous conditions.—It is now more than thirty years since Keen first asserted that
pigmented moles may, under certain circumstances, develop into Cancer, an assertion which has been
abundantly confirmed by many surgeons since then. The list of conditions accused on more or less
substantial evidence of being pre-cancerous is very large, and includes such varied phenomena as
elevated angioma, X-ray dermatitis, rodent ulcer, adenoma, lymphangioma, tuberosum multiplex,
etc.
(2) Local Manifestations of Other Diseases.—The chief conditions of this kind which have been
associated by various observers with Cancer are lupus (tuberculosis of the skin), leukoplakia (of the
tongue), syphilis and psoriasis. It is an undoubted fact, at any rate, that Cancer is not infrequently
superimposed upon local manifestations of other diseases, upon the tissue subjected to chronic irritating
discharges or upon the scar tissue resulting from such local lesions.
(3) Sources of Chronic Inflammation and Irritations.—I have emphasised the very great importance
of this factor when discussing the causation of Cancer. Many different kinds of irritants
may aid in the production of a malignant tumour, chemical, mechanical, actinic or bacterial. There
are very few portions of the body which are exempt from one or other of the various forms of irritation.