Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-22T21:06:24.889Z Has data issue: false hasContentIssue false
  • English
  • Français

A Study of the Incidence of Cancer of the Lung and Larynx

Published online by Cambridge University Press:  15 May 2009

N. M. Kennaway  and
E. L. Kennaway
N. M. Kennaway
Affiliation:
From the Research Institute, the Royal Cancer Hospital (Free), London
E. L. Kennaway
Affiliation:
From the Research Institute, the Royal Cancer Hospital (Free), London
Rights & Permissions [Opens in a new window]

Xiiisummary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The death certificates for cancer of the lung and of the larynx in males from England and Wales for the years 1921–32 inclusive, numbering 18,280, have been investigated.

Sources of error in statistical work on death certificates are discussed.

Latterly autopsies have been made upon about 28 per cent, of cases of cancer of the lung, and 9 per cent, of cases of cancer of the larynx. The increase in the recorded cases of lung cancer is not nearly accounted for by the increase of data obtained by autopsy.

The agricultural and coal-mining industries show a low incidence of cancer of the lung and of the larynx.

The factors which lead to silicosis appear not to be very active in producing cancer of the lung or larynx, but in metal grinders the incidence of cancer of the lung is 2¼ times that in the general population. A group of open-air occupations, where there is exposure to the dust of roads, have rather high ratios for cancer of the lung and of the larynx with the exception that motor drivers have a normal liability to cancer of the larynx. On the whole, no occupation involving exposure to any kind of dust has been found in which there is any very high incidence of cancer of the lung or larynx. Cases of cancer of the lung in asbestos workers are described in recent literature, but none has been found among the certificates considered here (up to 1932).

Workers exposed to coal gas and tar, and those engaged in the preparation and sale of tobacco, tend to show an increased prevalence of cancer of the lung.

Occupations concerned with the supply of alcohol have a high incidence of cancer of the larynx.

To investigate the occupational incidence of cancer thoroughly one should have before one, simultaneously, comparable figures for cancer of all parts of the body which could be effected by an external agent.

With regard to the view, that the recent rapid increase in recorded deaths from cancer of the lung is due to the detection of more cases by improved diagnosis, the very moderate ratio (129) for cancer of the lung in medical men is noteworthy, for this is an occupation where the availability of the existing methods for the detection of cancer is presumably at a maximum.

Data are given of the prevalence of cancer of the lung and larynx in men and in women, and of the rate of increase in the two sexes in recent years. The greater incidence of cancer of the lung upon men than upon women is discussed. The recent rate of increase of cancer of the lung in men is found to be not much greater than that in women, when these increases are reckoned in percentages.

The increase in recorded cases of cancer of the lung may be due to (1) an actual increase; (2) improvement in diagnosis; (3) fashion in diagnosis; or to any combination of these factors. A comparison is made between the increase of cancer of the lung, and of cancer of the prostate; the number of deaths attributed to cancer of the prostate appears to have reached a steady level.

No special occupations have been found to which the increase in the total of cases of cancer of the lung can be attributed; rural workers show an increase which is not much less than that in the general population.

No evidence has been found that tarring of roads has affected the incidence of cancer of the lung upon the general population. Such data as are available suggest that coal tar in the atmosphere, whether derived from roads, domestic chimneys, or any other source, does not readily give rise to cancer of the lung. Cotton-mule spinners show an especially small liability to cancer of the lung although they inhale air sprayed with an oil which produces cancer of the skin.

Improvements in diagnosis must have led to the detection of a larger proportion of the existing cases of cancer of the lung; whether there has been an actual increase in these cases cannot be decided from the data presented here, but a source of evidence on this question is suggested.

We are indebted to the Registrar-General for the data considered in this paper, and also for kindly permitting us to use some figures which have not yet been officially made public. We have received much assistance in the classification of occupations from some members of the Staff of the General Register Office, to whom we wish to express our gratitude. We wish to thank also Dr J. C. Bridge, Senior Medical Inspector of Factories, for information upon various matters, and especially upon silicosis. We are greatly indebted to Miss L. D. Henderson for much assistance in carrying out the calculations.

Type
Research Article
Information
Journal of Hygiene , Volume 36 , Issue 2 , June 1936 , pp. 236 - 267
Copyright
Copyright © Cambridge University Press 1936

References

Note. No attempt is made in this paper to review the statistical literature of cancer of the lung. See Bonser, G. M. (1934), J. Hygiene, 34, 218.CrossRefGoogle Scholar
Andervont, H. B. (1935). The production of dibenzanthracene tumours in mice. Public Health Reports, U.S. Treasury Dept. 50, 1211.CrossRefGoogle Scholar
Argyll, Campbell J. (1934). Cancer of skin and increase in incidence of primary tumours of lung in mice exposed to dust obtained from tarred roads. Brit. J. Exp. Path. 15, 287.Google Scholar
Bridge, J. C. (1931). Annual Report of the Chief Inspector of Factories and Workshops for the. Year 1930. London: H.M. Stationery Office.Google Scholar
Bridge, J. C. (1935). Ibid. for 1934.Google Scholar
Cohen, J. B. and Ruston, A. G. (1925). Smoke. A Study of Town Air. London.Google Scholar
Dible, J. H. (1934). Silicosis and malignant disease. Lancet, ii, 982.CrossRefGoogle Scholar
Gloyne, S. R. (1935). Two cases of squamous carcinoma of the lung occurring in asbestosis. Tubercle, 17, 5.CrossRefGoogle Scholar
Henry, S. A. (1928). Mule spinners' cancer: the time necessary for its production. J. Hygiene, 28, 100.CrossRefGoogle ScholarPubMed
Henry, S. A., Kennaway, N. M. and Kennaway, E. L. (1931). The incidence of cancer of the bladder and prostate in certain occupations. Ibid. 31, 125.CrossRefGoogle Scholar
Kimura, N. (1923). Artificial production of a cancer in the lungs following the intra-bronchial insufflation of coal-tar. Japan. Med. World, 3, 25.Google Scholar
Lehmann, K. B. (1930). Die Teerstrassen vom Standpunkt der Hygiene. Arch.f. Hygiene, 104, 105.Google Scholar
Lynch, K. and Smith, W. A. (1935). Pulmonary asbestosis III. Carcinoma of lung in asbesto-silicosis. Amer. J. Cancer, 24, 56.CrossRefGoogle Scholar
Moore, R. A. (1935). Morphology of small prostatic carcinoma. J. Urol. 33, 224.CrossRefGoogle Scholar
Murphy, J. B. and Sturm, E. (1925). Primary lung tumours in mice following the cutaneous application of coal tar. J. Exp. Med. 42, 693.CrossRefGoogle ScholarPubMed
Passey, R. D. (1922). Experimental soot cancer. Brit. Med. J. ii, 1112.Google Scholar
Passey, R. D. and Holmes, J. Mcd. (1935). The incidence of intrathoracic neoplasia in the teaching hospitals of Great Britain, 1894–1928. Quart. J. Med. N.S. 4, 321.Google Scholar
Report (1926) of the Departmental Committee appointed to consider Evidence as to the Occurrence of Epitheliomatous Ulceration among Mule Spinners (Home Office). London: H.M. Stationery Office.Google Scholar
Rich, A. R. (1935). On the frequency of occurrence of occult carcinoma of the prostate. J. Urol. 33, 215.CrossRefGoogle Scholar
Rostoski, , Saupe, and Schmorl, (1926). Die Bergkrankheit der Erzbergleute in Schneeberg in Sachsen (“Schneeberger Lungenkrebs”). Z. f. Krebsforsch. 23, 360.Google Scholar
Schabad, L. M. (1932). Experimentelle atypische Epithelwucherungen nach intratracheo-bronchialer Einführung des Steinkohlenteers in die Lungen. Ibid. 38, 154.Google Scholar
Schabad, L. M. (1935). Ueber die cancerogene Wirkung des 1:2:5: 6-Dibenzanthracens. Ibid. 42, 295.Google Scholar