Increasing time trends in the recorded incidence of childhood cancer have been reported in many different settings. The extent to which these trends reflect real changes in incidence, rather than improvements in methods for diagnosis and registration, is controversial. Using data from the National Registry of Childhood Tumours (NRCT), this thesis investigates time trends in cancer diagnosed under age 15 in residents of Britain during 1966-2005 (54650 cases), and considers potential sources of artefact in detail. Several different methods are used to estimate completeness of NRCT registration. The history of methods for diagnosis and registration of childhood cancers in Britain is described, and predictions are made for effects on recorded incidence. For each of the 12 main diagnostic groups, Poisson regression is used to fit continuous time trends and ‘step’ models to the annual age-sex-standardised rates by year of birth and year of diagnosis. Age-specific rates by period, and quinquennial standardised rates for diagnostic subgroups, are shown graphically. For three broad groups (leukaemia, CNS tumours and other cancer), geographical variation is compared by period of diagnosis. The results of these analyses are discussed in relation to the predicted artefacts. The evidence for a positive association between affluence and recorded incidence of childhood leukaemia is briefly reviewed. A special form of diagnostic artefact, the ‘fatal infection’ hypothesis, is proposed as an explanation of both this association and the leukaemia time trend. This hypothesis is examined in a novel test based on clinical data. The recorded incidence of childhood cancer in Britain increased in each of 12 diagnostic groups during 1966-2005 (from 0.5% per year for bone cancer to 2.5% for hepatic cancer, with 0.7% for leukaemia). Evidence presented here suggests that these increases are probably artefacts of diagnosis and registration. The potential implications for epidemiological studies of childhood cancer should be considered.

Die Reaktionen von Hochschullehrern und Unternehmern auf Bildungsreformen und -expansion in Westdeutschland und Britannien nach dem Zweiten Weltkrieg sind Gegenstand dieser Arbeit. Sie untersucht, wie sich beide Gruppen zu Hochschul- und Schulreformen im Besonderen und zur sozialen Öffnung im Allgemeinen äußerten. Welche bildungs- und hochschulpolitischen Interessen verfolgten diese Gruppen? Mit welchen Argumentationen versuchten sie, ihre Interessen durchzusetzen? Spielten bürgerliche Werte und Bildungsideale dabei noch eine Rolle? Herrschte eine bildungspolitische Werte- und Interessenübereinstimmung zwischen Hochschullehrern und Unternehmern, und knüpften sie gemeinsame Netzwerke zur Durchsetzung dieser Interessen? Die Arbeit bietet im ersten Teil einen Überblick über bildungspolitische Veränderungen und über gesellschaftliche Entwicklungstendenzen der Vermögens- und Einkommensverteilung sowie der Einordnung der beiden Akteursgruppen in die jeweilige Prestige- und Sozialstruktur ihrer Länder. Im zweiten Teil folgt eine Analyse ihrer bildungspolitischen Aussagen auf Hinweise einer Existenz von bürgerlichen Werten und Abgrenzungsversuchen gegenüber nicht-bürgerlichen Schichten. Im dritten Teil werden schließlich bildungspolitische Netzwerke und Gremien nach ihrer Zusammensetzung und -arbeit betrachtet. Damit möchte die Arbeit einen Beitrag zur Frage leisten, ob nach 1945 weiterhin ein Bürgertum mit einem Berufsgruppen übergreifenden Standesbewusstsein existierte, oder ob dieses in einzelne Berufsgruppen wie Hochschullehrer und Unternehmer mit je eigenen Interessen und Identifikationen zerfallen war. / This thesis compares the responses of university lecturers and business people to educational reform and expansion in West Germany and Britain in the postwar period. It examines how these groups reacted to increased social mobility in general, and university and school reform in particular. How did they attempt to persuade others of their position? Did middle-class values and educational ideals play a role? To what extent did the values and interests of university lecturers and business people intersect, and did they create networks to achieve their goals? The first part of this study surveys the postwar social and educational landscape, changes in income and wealth distribution, as well as the position of university lecturers and business people in each country. Part two analyses both groups’ positions on education, with particular reference to the existence of middle-class values and attempts to define themselves in relation to other classes. The final part explores how networks and bodies on education issues were set up and how they pursued their work. This study contributes to the debate as to whether a middle-class group identity existed in the postwar period, or whether this identity had disintegrated into individual professional groups, each with their own interests and identifications.