A screening project consisting of 10,362 men was designed to detect early lung cancer. Half of the subjects had sputum cytologic studies and chest radiographs, and the other half had chest radiographs. Seventy cases of bronchogenic carcinoma were detected. Eight patients had malignant cells in their sputum and normal chest radiographs, and 62 patients had radiographic evidence of bronchogenic carcinoma. After clinical assessment including bronchoscopy, percutaneous needle biopsy, mediastinoscopy, and mediastinotomy in selected cases, 48 of the patients underwent exploratory thoracotomies. Six patients had benign disease. Thirty-nine of the remaining 42 patients had tumors resected for cure, an overall resectability rate of 55%. Staging was accomplished after resection and histologic examination of the operative specimens. Five patients with Stage 0 carcinoma have survived a median of 36 months without evidence of recurrence. Twenty-six patients had Stage I disease, and 77% have survived a median of 36 months without recurrence. Four of these patients have developed second primary tumors. Of the seven patients with Stage II disease, three are alive 40 to 50 months following operation. Seventeen patients had Stage III disease, two of whom have survived. Nine patients with oat cell carcinoma were treated by irradiation and chemotherapy, and all are dead. The median survival was 8 months. The results of this study are encouraging. However, long-term follow-up is necessary to demonstrate whether early detection by sputum cytologic studies and chest radiographs and the apparently improved survival of these patients will result in a decreased death rate from bronchogenic carcinoma. The high initial survival rates may be due simply to earlier intervention in the natural history of disease.
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine