On changes in the recorded mortality from cancer and their possible interpretation / by Major Greenwood, jun., and Frances Wood.

  • Greenwood, Major, 1880-1949.
Date:
1914
Catalogue details

Licence: In copyright

Credit: On changes in the recorded mortality from cancer and their possible interpretation / by Major Greenwood, jun., and Frances Wood. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    practitioner being actually placed upon paper, and of cases of cancer thus being caught in the Eegistrar-General’s net, was far greater now than it was fifty years ago; this was so even if it were assumed—and it was a very doubtful assumption—that the diagnostic skill of the average practitioner had not greatly improved. He would call upon Dr. Stevenson to open the discussion. Dr. T. H. C. Stevenson said he had listened with much interest to Mr. Greenwood’s and Mrs. Wood’s paper, on which he had only one or two remarks to offer, and those chiefly relating to his own personal connexion with a portion of its subject-matter. From the manner in which his contribution on the subject of cancer to the last Annual Eeport of the Eegistrar-General had been referred to in the paper, he was a little afraid that it might appear that he had there taken up a definite position in favour of the view that cancer mortality is not increasing in this country, and that he claimed to support this view by arguments deduced from the figures there quoted. So far from this being the case, he believed that the one fact with regard to this question which emerged with something approaching certainty from the study of the official records was that cancer of certain parts of the body—the tongue at all events, if not others—had increased, and in view of this fact very strong evidence would be required to support a definite conclusion against the increase of cancer in general. With the permission of the meeting he proposed to read some of the context in which his question, quoted by the authors of the paper, was set. “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 harmonize sufficiently well 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 these latter point in the same direction then we must ask ourselves whether E. and W. in 1911 does not compare with E. and W. in 1881 more or less as London in 1911 does with the rural districts in 1911.” It would he seen that the question was not even put, hut merely suggested as one which, under certain circumstances, might have to be put in the future. To bring forward an elaborate array of statistical calculations in order to counter such a hypo- thetical possibility of a question as this, seemed to him like using a very heavy steam-hammer to crush a very small nut. He wished also to refer to the suggestion that the mortality records of different areas should be tabulated according to the part of the body affected. There would he no difficulty in doing so for the years 1911 onwards, when the system had come into operation in the General Eegister Office by which each death registered was represented by a card, which in the case of cancer bore a record of the part of the body affected. It would hardly he worth while, perhaps, to undertake such work until the records ofja few years had accumulated, unless the areas compared