Clinical lung cancer
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Clinical lung cancer · Jul 2004
ReviewComputerized tomographic nodule heterogeneity: present and future impact on indications for sublobar resections.
With the advent of lung cancer screening, many nodules are being detected that are subsequently proven to be lung cancer. These nodules have different radiographic appearances and different biologic characteristics regarding their invasiveness and propensity for metastasis. These solid and part-solid nodules are now having surgeons reassess issues of lung sparing for early-stage lung cancer by not only considering smaller nodules as potentially appropriate for wedge resection or segmentectomies, but are also requiring surgeons to stratify these lesions by radiographic appearance. Data that argue for considering lesser resection of selected early-stage lung cancers, as well as the need for more prospectively accumulated facts that arise from trial designs like the original randomized Lung Cancer Study Group Trial, are discussed.
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Clinical lung cancer · May 2004
Review Historical ArticleThe global smoking epidemic: a history and status report.
The World Health Organization estimates that tobacco causes approximately 5 million deaths annually worldwide, a number expected to double by 2025. Cigarette consumption grew from only a few billion per year in 1900 to present values of approximately 5.5 trillion worldwide. Historical causes for the rise of smoking include the invention of flue curing, safety matches, and cigarette rolling machines, but also the distribution of cigarettes to soldiers during World War I, mass marketing, the failure of governments to limit consumption, and the duplicitous denial of hazards by manufacturers. ⋯ Instead, the industry sought to target physicians and others with its message of "no proof," using subtle techniques of deception, including the funding of spurious research, duplicitous press releases, propaganda efforts directed at physicians, and the employment of historians to construct exculpatory narratives. The World Health Organization's Framework Convention on Tobacco Control promises to standardize global tobacco control measures, including policies to limit smuggling. Effective means of reducing tobacco use include counter-advertising, increased taxation, smoke-free workplace legislation, and litigation against the industry.