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Among the factors often mentioned as responsible for the undeniable fact that more deaths from cancer have been recorded in recent years than formerly is the increment of cases of cancer recognized at necropsy that were unrecognized during life. These added cases help to swell the cancer death rate; and hence, the more advanced the medical profession of a given community, the more necropsies, and the smaller the number of cancers that escape inclusion in the vital statistics of the community. The experience of necropsy disclosure of a clinically unrecognized malignant growth is so common that this factor is always brought forward when the alleged increase in the frequency of cancer is under discussion; and it is universally admitted. Despite the recognition and acceptance of this factor, however, we have very little in the way of actual evidence as to its real importance. The most quoted paper is that of
H. Gideon Wells (1923) studied this question.