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of the lung every half an hour. This complaint is already causing oneeighteenth
of the deaths of all males, one-ninth of the deaths of males in
the ages forty-five to sixty-four. It is said that one in eight of those men
who are smoking twenty cigarettes a day will develop cancer of the lung,
a marked contrast to the one in 300 of non-smokers. The other reason is
that, serious as are these figures today, they are steadily rising. In 1951
something over 13,000 people in this country died from cancer of the
lung; in 1952 over 14,000, in 1953 over 15,000, in 1954 16,000, in 1955
17,000, in 1956 over 18,000 and in 1957 over 19,000. It is predicted that
this figure will rise in this country to 25,000; and that is the picture
wherever cigarettes are being smoked. Each year, half a million people
die in this country. Of these, nearly 50,000 die from cancer; and of these,
one-third of these deaths in men are due to cancer of the lung. This
condition is now causing each year more than four times as many deaths
as tuberculosis and four times the number of deaths on the road.
It has been suspected for some time that the condition of the air we
breathe is one of the factors in the aetiology of the disease, suspicion
falling on such carcinogens as benzpyrene or arsenic present in the air in
urban communities and which have their origin in the smoke from the
industrial and the domestic chimney. This atmospheric pollution could
account for the higher incidence of the complaint amongst those of the
same ages living in urban as compared with rural communities, and
could account for the higher incidence amongst those living on the northeastern
side of London as compared with those living in the south-west,
those on the lee-side breathing air which has been contaminated in its
passage over London But in general the atmosphere is less polluted than
it was, and yet cancer of the lung is commoner. Atmospheric pollution,
then, is not the explanation, and is suspected of being responsible perhaps
at the outside for twenty per cent. of the cases. If it were a very important
factor, non-smokers and women would not be so relatively immune.
Those in certain occupations are exposed to increased risks of
contracting cancer of the lung. Certain coal mines have high levels of
radio-activity. Those exposed to lubricating oils and to metallic dusts
and fumes and those working with tars and oils obtained by the destructive
distillation of coal are more at risk. But all these comprise small numbers,
and most people are not exposed in this way. While important to the
individual, then, they are not of concern to the general body of the
population.
For some years now in other countries and in this, attention has
been focussed on smoking as a factor. Many statistical enquiries have
been carried out and much research into the recognition of carcinogens
and the presence of carcinogens in various substances. In 1954 a Ministry
of Health report said: "It must be recorded as established that there is
a relationship between smoking and cancer of the lung; but though
there is a strong presumption that the relationship is causal, it is not a
simple one."
When two series of figures run in parallel, they may be associated.
Such association might be one of cause and effect, or it might be that
though the two series are independent of each other they are both due to
some common factor. In many series of parallel figures though there might