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j 194 OCCUPATIONAL TUMORS AND ALLIED DISEASES INCIDENCE AND DISTRIBUTION OF CHIMNEY-SWEEPS' CANCER Year 1910-1912 1913-1914 1921-1922 1923 Head and Neck Arm, Hand, Trunk, Foot, Leg 0 2 data not available 0- 0 0 0 Penis 1 1 2 1 Scrotum 16 7 10 4 Henry analyzed the fatalities from scrotal cancer in England and Wales during the years 19 n to 1935 in their relation to occupation and found that among a total of 1,747 cases 103 were present in chimney-sweeps (6.9 per cent). These occupational cancers were divided as follows upon the quinquen nial period: 1911-1915: 22 cases; 1916-1920: 20 cases; 1921-1925: 25 cases; 1926-1930: 17 cases; 1931-1935: 19 cases. While the absolute figures on chimney-sweeps' cancer of the skin are not very impressive when compared with those recorded for mule-spinners' cancer, which also most often attacks the scrotal skin, consideration must be given to the fact that there is a much smaller number of chimney-sweeps em ployed than mule-spinners. Data concerning the relative incidence of chimney sweeps' cancers have been recorded by several investigators. Legge, during 1910- 1912, stated that 29 per cent of the deaths of chimney-sweeps were caused by scrotal cancer compared with 1 per cent from this cause in the general population. Kennaway and Kennaway, who determined the inci dence of scrotal cancer in England and Wales for the years 1911 to 1935, noted 100 cases of fatal scrotal cancer among 5,274 sweeps, while the total number of'deaths from scrotal cancer among the male civil population over twelve years of age (13,901,108) in this period was 1,486 cases, of which only 888 were nonoccupational. Leitch estimated from the incidence figures of scrotal cancer among sweeps during the years 1910-19x2, 1921, and 1923 that there died 4.6 sweeps every year from this disease, or, as the total number of sweeps in England and Wales was 5,251, one sweep out of 1,140 died every year. The excessive incidence of scrotal cancer in chimney-sweeps is reflected also in an observation of Kennaway, who found that in years 1911-1912 one out of every four deaths caused by cancer in chimney-sweeps was due to a scrotal malignancy, while the ratio for the general population was one scrotal cancer to 560 cancers of all organs. This investigator stated that there was no evidence that chimney-sweeps' cancer had become less frequent during 1910 to 1923. This condition seems to have continued during the following years, as Henry found that the crude death rate from scrotal cancer in chimney-sweeps was the same during the quinquennial periodsTqi 11915 and 1931-1935. A similar result was reported by Henry and Irvine