Summary.-The resident population of Greater Bombay was analysed for the incidence of lung cancer and other variables of possible significance to lung cancer incidence. During a 10-year period from 2177 lung cancer cases (1861 males, 316 females) were registered, from a population pool consisting of 5-24 million persons (3.07 million males, 2-17 million females). The average annual incidence of lung cancer was 13-6 per 105 males but only 3*3 per 105 females, age-adjusted to the Standard World Population. The incidence in non-Parsi males (14*0) was almost double the figure in Parsi males (6.8). There was however no significant difference in incidence between non-Parsi (3.8) and Parsi females (3.3).Time-trend analyses did not reveal statistically significant differences in the incidence of lung cancer in any particular (male or female) age group.The data from death certificates for the same 10-year period 1964-73, showed that the age-adjusted rates (standardized to the world population) were 11-0 and 3-3 per 105, for males and females, in the total population.In a retrospective study, 792 males with lung cancer (42.6% of 1861 male cancer patients) for whom detailed smoking history is available, were matched for age and community with randomly selected controls, obtained from the voters list of the Greater Bombay Corporation, and significant statistical association was found between tobacco smoking and lung cancer. All smokers appear to be at high risk (16.8) compared with non-smokers. The relative risk in bidi smokers was however 19-3, even higher than in cigarette smokers (8.6). Hindu, Muslim and Christian smokers are apparently at identical risks. A dose-response relationship was found in bidi and cigarette smokers.CANCER of the lung is of epidemiological interest because of the widespread geographical and racial variations observed and the steadily increasing incidence and mortality noted in Western countries. This increase has so far been noticed particularly in men, but recently women have also begun to present a similar rising risk pattern.A number of investigators have shown that the major factors leading to cancer of the lung are cigarette smoking and air pollution. We have tried to evaluate whether these factors also operate to a similar or varying degree in the residents of Bombay, who are apparently at low risk but who smoke both the bidi and the cigarette. Cigars and pipes are also smoked by men in Bombay, but are relatively new

Dentists are at risk for developing musculoskeletal problems. This provided the impetus for a study of prevalence, distribution, and the associated risk factors of these problems in the dentist population of Madhya Pradesh, India. The data were analyzed from 213 dentists of Madhya Pradesh, India, who fulfilled the inclusion criteria and gave their consent for this cross-sectional study. Subjects were assessed by a special questionnaire using demographic details with working conditions. Chi-square test was used for the statistical analysis of the data. Of total 213 participants, 83.10% had at least one musculoskeletal pain in the past 12 months. Low back pain was most frequent (57.75%) followed by neck pain (31.17%) and wrist pain (17.84%). The pain was significantly prevalent among the group who worked in direct vision, without assistant, in standing position or following none of the fitness regimen.

(24).The average annual age-adjusted (world population) incidence rates, however, were found to be 48-5 and 18-2 per 100,000 in the Parsis and non-Parsis respectively, with an average of 19-9 per 100,000 for the total population. For reasons not yet clear, in every age group the incidence rate in Parsis was 2 to 3 times higher than in the non -Parsis.Time-trend analyses of our data do not reveal any statistically significant increase or decrease in the incidence of breast cancer in any particular age group.Data from death certificates for the same 9-year period show that the age-adjusted mortality rate (world population) is 9-2 per 100,000/year.

The relative frequency of histologically diagnosed cancer at the Chiang Mai Medical School in North Thailand in 1964-67 inclusive is examined. Most of the 1877 cancers seen are in Thais (males, 927; females, 908), the remainder arising in Chinese (males, 21; females, 12), Hill People (males, 6; females, 1) and others (females, 2). The cancers in Thais are presented by site, sex and 10-year age-group together with the relative frequency (crude and corrected for age). In Thais, the outstanding finding is the extraordinarily high frequency of cancer of the hypopharyngeal-laryngeal region in both sexes (males, 18.4 per cent; females, 3.4 per cent). This may be associated with the smoking of a local variety of the cigar called “keeyo” This cigar, smoked in the usual manner, contains approximately equal quantities of home-grown, sun-dried, Thai tobacco and the chopped bark of the “koi” tree ( Streblus asper ). In women, who also smoke “keeyo”, the frequency of hypopharyngeal-laryngeal cancer is unusually high by occidental standards. There is no sex difference in the frequency of bronchial cancer (4 per cent). In males cancer of the penis, in second rank (6.6 per cent) is much more frequent than cancer of the prostate and testis combined. Stomach and skin cancers (ICD 191) are in third place (each 5.7 per cent). In females the most frequent cancers are cervix uteri (19.8 per cent), breast (8.8 per cent) and skin (ICD 191) (6.1 per cent). Cancers of the lip and skin of the head and neck are more frequent in females than in males. Choriocarcinoma is common (1.9 per cent) and there is a large number of vulvar cancers in young women (2.6 per cent). The geography, economy and medical facilities of Chiang Mai Province are described. It is considered that, although there is likely to be considerable under-reporting of internal cancers, the high frequency of hypopharyngeallaryngeal cancer is not due to selective bias. Images Fig. 2

SUMMARY.-A series of 458 cases of carcinoma of the penis occurring in Ugandan Africans is analysed. These were derived from the records of a country-wide biopsy service over the 5-year period 1964-68. Where circumcision is practised the incidence of this tumour is very low. However, the geographical variation also showed marked differences in the uncircumcised, regardless of tribal antecedents and sometimes over quite small distances. The expansion of the Kampala Cancer Registry to cover the whole of Uganda has been described by Hutt and Burkitt (1965) and Hutt and Wright (1967). As a result of this country-wide survey more information is now available than to previous workers. It was therefore decided to reassess the geographical pattern of penile carcinoma in the uncircumcised and circumcised tribes of Uganda over the .5-year period 1964-68. METHODS CasesAll surgical biopsies of the penis submitted for histopathological examination from Uganda during 1964--68 were reviewed. This analysis is restricted to histologically diagnosed carcinomas of the penis. There were 458 such carcinomas including I I verrucous carcinomas and 13 well differentiated squamous cell tumours. This last group was included because of tissue invasion despite an overall appearance of benignity. Twenty-three precancerous lesions were excluded.*On secondment to Makerere Medical School.