Recent trends in mortality from lung cancer and bronchitis in urban and rural areas in Scotland.

Abstract

The steady and persistent rise in mortality from lung cancer has been a marked feature of the national statistics for many years. More recently the increas ing number of male deaths attributed to bronchitis has given rise to concern. The association of both diseases with cigarette smoking has been established beyond any reasonable doubt in numerous studies in many parts of the world. In Britain, surveys of cigarette smoking have, in recent years, been under taken by the Tobacco Research Council (Todd, 1966). Waller (1959) has suggested that cigarette smoking occurred earlier in London than in the rural areas of England and Wales and predicted, on the basis of this hypothesis, that the death rates for lung cancer in rural areas would, in time, approach the rates in London and other large towns. Buck and Brown (1964) examined standardized mortality rates and standard mortality ratios in men in urban and rural areas in England and Wales from 1952 to 1961. They found that over this period the rates rose steadily in parallel, and concluded that their data did not support Waller's hypothesis. They did not, however, take into account the proportionate scale of these changes, nor did they examine different age groups. It has been noted recently (Smith, 1964: Springett, 1966) that whereas the total lung cancer mortality has been increasing steadily, the rise in the younger males has been slowing down, and at some ages has become stationary. In view of these findings it was thought to be of interest to examine the age-specific death rates in Scottish males in urban and rural areas separately. Such a study might uncover trends that remained concealed when all ages were combined. It was thought valuable also to examine mortality from bronchitis in the same way in view of its aetiological association with smoking.