By Katherine Camp
In the United Kingdom, cancer was beginning to become more and more prevalent during the 1930s. The Medical Officer of Health for London County Council in 1954 stated that this rise in occurrence was caused by the changes in age structure of the population (MOH London County Council 1954, 144); people were surviving longer which means they had a higher chance of being diagnosed with cancer. Cancer was known as a “disease of mature age” (MOH London County Council 1954, 144).
More specifically, lung cancer prevalence rates were also increasing across the country. Before the eighteenth century, lung cancer was not even recognized medically by physicians because of how rare the disease was in people and as of “1900 only about 140 cases were known in the published medical literature” (Proctor, 1). Due to the unfamiliarity of this disease, there were different hypotheses about the causes of lung cancer. One of the hypotheses included the increase in people smoking cigarettes. England began manufacturing cigarettes during the 1850s due to the Crimean War, but consumption rose at the beginning of the 1900s (Clemmensen, 943). The MOH for Lewisham in 1962 found an increase in twenty-two percent for tobacco products being sold in the United Kingdom from 1951-1961; tobacco companies would promote smoking on posters with slogans like, “So cool-so smooth to the throat.” However, during this time, there was also propaganda against smoking being publicized to the country and the effect of it was negligible, and some even negative (MOH Lewisham 1962, 15). Another study found a significant negative correlation in the amount of bright sunshine received and lung cancer (MOH London County Council 1954, 144). There could have been various accounts for this correlation like people not receiving sunlight and feeling more depressed, so they turn to smoking to solve make them happier, or even the Great Smog of London in 1952 which caused severe air pollution for multiple days.
Trends Between Rural Versus Urban Areas
Within these potential causes, there were several trends that emerged from people who were being diagnosed with lung cancer and dying from it. One of the trends that was revealed was that there was a higher occurrence of people with lung cancer in urban areas compared to rural areas. According to the MOH London County Council of 1954, the number of death rates per 1000 people living from lung cancer was 1.15 for urban areas and .65 for rural areas (MOH London County Council 1954, 144). Some of the factors that contributed to this trend are overcrowding, social class, and amount of free space. Each of these factors are significant with a correlation coefficient of +0.431, +0.599, and +0.417 (MOH London County Council 1954, 144). Not only were these findings evident in central London, but also in districts surrounding it; Tottenham is a district of North London and heavily populated. In the MOH report of Tottenham in 1961, the officers reported there were “now sixty deaths a day or more than three times the mortality on the roads” (MOH Tottenham 1961, 5).
Trends Between Sexes
Another trend in lung cancer was between sexes. During this time, there were more men than women dying from lung cancer. In a MOH report of Lewisham in 1962, officers stated that more than twenty thousand men total died from lung cancer in the whole country the previous year (MOH Lewisham 1962, 16). In Hackney, during 1965, there were 136 men who died from lung cancer compared to only 35 women (MOH Hackney 1965, 15). In Greenwich, the medical officer listed average deaths of males and women every year over a ten-year period (1951-1961) and found that the men’s average was 38.8 and the women’s average was 6.4 (MOH Greenwich 1961, 34). In East Ham, there was a similar trend of men dying from lung cancer more than women in the area. However, there was another significant finding that was published in the MOH report of East Ham. The officers pointed out that even though there were more men than women dying from lung cancer every year, “there is a steady increase in the number of women who succumb from cancer of the lung each year…whereas deaths in men [from lung cancer] remain about the same” (MOH East Ham 1955, 6). These findings are also evident nearly ten years later in Lewisham in 1968. In the MOH report of Lewisham, the officers list the number of deaths from lung cancer over the past ten years and the results are parallel; although there are more deaths from lung cancer for men than women every year, the number of deaths in men are remaining stagnant and the number of deaths in women are steadily increasing. For men, in 1959 there were 42 deaths from lung cancer and in 1968 there were 44 deaths, whereas for women, in 1959 there were 9 deaths from lung cancer and in 1968 there were 14 deaths (MOH Lewisham 1968, 14). A possible explanation for the rise in lung cancer in women could be due to women working more in factories during World War I due to the demands of the war. While working in these factories, many women were introduced to cigarettes which led to an increase in consumption of carcinogens.
Lung Cancer Versus Other Cancers
An astonishing finding during this time period was the incidence rate of lung cancer compared to other cancers. In the MOH report for Greenwich in 1969, lung cancer had the highest rate of occurrence compared to any other cancer like breast, intestine, and stomach; out of 565 deaths from cancer during that year, 158 people died from lung cancer (MOH Greenwich 1969, 53). The report goes even further to state that “the present total of 29,768 for England and Wales with a calculated rate of .61 indicates an average yearly increase of 3.5% over the last decade” (MOH Greenwich 1969, 53). There were similar results in the prevalence of lung cancer in the United States. In males, it was the second most common diagnosed cancer and in females, it was the third most common (Benedek and Kiple, 104). Along with England, “smoking [in the United States] has now been common in women long enough to be reflected in an alarming increase in the incidence of lung cancer” (Benedek and Kiple, 106). This shows how an increase in lung cancer and smoking was not just rising in England, but across the globe.
Lung cancer in England was nearly non-existent until the turn of the twentieth century. Men began smoking cigarettes more often because companies started manufacturing them in the country and many women began smoking during the rise of World War I. Since lung cancer can take years to develop, this could be why the prevalence rate really began to skyrocket near the 1930s-40s and increased from there. During this time, people saw correlations between cigarette smoking and lung cancer, but it was not fully confirmed until years later. Overall, despite the trends of death rates between sexes, urban or rural areas, and other cancers, the facts were clear that the prevalence of lung cancer was increasing every year.
- MOH London County Council 1954
- MOH Tottenham 1961
- MOH Lewisham 1962
- MOH Hackney 1965
- MOH East Ham 1955
- MOH Lewisham 1968
- MOH Greenwich 1961
- MOH Islington 1958
- MOH Greenwich 1969
- MOH Lewisham 1962
- Benedek, Thomas G, and Kenneth F Kiple. “Concepts of Cancer.” In Cambridge World History of Human Disease, 102–9, 1993.
- Clemmensen, Johannes. “Lung Cancer From Smoking: Delays and Attitudes, 1912-1965.” American Journal of Industrial Medicine, 1993, 941–53.
- Proctor, R. 1-6. BMJ Journals- Cigarette-lung cancer link