Real and apparent differences in the incidence of cancer / by E.F. Bashford.

  • Bashford, Ernest Francis, 1873-
Date:
1907
Catalogue details

Licence: In copyright

Credit: Real and apparent differences in the incidence of cancer / by E.F. Bashford. 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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    similar. The death rate of a population is the most—and probably the only—reliable method of estimating the frequency of cancer. All other methods, such as the German “ cancer-census,” the study of the frequency in the experience of life-assurance societies, the comparison of the numbers of cases in hospital practice in which no basis for comparison exists, introduce either new sources of fallacy, or magnify those inherent in mortality statistics. The errors in diagnosis made in general practice are probably greater than in hospital practice, for they are made under less favourable circumstances. In endeavouring to estimate the importance of the variations in the incidence of cancer, I shall attach great importance to the very wide limits within which the primary data may vary qualitatively and quantitatively under different circumstances. Apparent Differences in the Recorded Incidence of Cancer in Europe. There are differences in the number of deaths assigned to cancer in civilised countries. Owing to their exceptional characters, I do not propose to touch upon the statistics of the United States or of the Australasian Colonies. In Europe, e.g., the rate of mortality varies from 0.33 in Hungary to 1.26 in Switzerland. It may not be only a coincidence that the largest number of deaths assigned to cancer occurs in Switzerland1, where medical inspection of the dead body is customary, and where in 1900 in 15 of the largest towns autopsies were made in so high a pro- portion as 25.7 per cent, of the total deaths. 1 cannot refrain from pointing out that the number of deaths assigned to cancer increases from one country to another in a manner parallel with the increasing accuracy of the vital statistics of the several countries. Thus, for example, the Prussian statistics are known to be less reliable than those compiled by Dr. Tatham for England and Wales, and the rate of mortality from cancer is 0.57 as compared with 0.79. The recorded death-rate from cancer in Ireland is much smaller than in the rest of the United Kingdom, beiim 0.57, equal to that of Prussia ; and I may take this difference as a special test case, because a possible explana- tion has been arrived at for Ireland. The discrepancy between the recorded incidence of 1 Of., however, p. 11, for factors artificially augmenting the number of deaths from cancer.