Swiss medical weekly
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Swiss medical weekly · Sep 1987
Clinical Trial[Early diagnosis of bronchial carcinoma using thoracic roentgen imaging and sputum cytology].
Chest roentgenography and sputum cytology have been used for the early detection of lung cancer since the beginning of the 1950s. Surprisingly, the yield of screening is sufficiently high. In view of the estimated prevalence of lung cancer of 0.5-2% in high risk persons, the detection rate was 0.32-0.95% in three large randomized clinical trials (Cooperative Pilot Study of the American Cancer Society and Veterans Administration 1969, Canadian study of Grzybowski and Coy 1970, National Cancer Institute Cooperative Early Lung Cancer Detection Program 1984). ⋯ The prognosis of lung cancer detected by screening is good: more patients survive, and they live longer than unscreened patients. The overall 5-year survival of patients screened by chest X-rays and sputum cytology of the NCI-study was 35-55% compared with only 15% of patients not screened. However, whether long survival means reduced mortality is uncertain, since long survival only reflects early detection.
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Swiss medical weekly · Sep 1987
Clinical TrialDetection of lung cancer: highlights of the Memorial Sloan-Kettering Study in New York City.
1. Patients with Stage 1 lung cancer detected by cytology or x-ray, and treated by complete resection, have a high probability of survival. 2. Sputum cytology is effective in early detection of slow growing squamous (epidermoid) carcinomas of lung, which in our population account for less than one-third of cases. ⋯ However, 40% of all lung cancers were detected in Stage 1, and at least two-thirds of patients with Stage 1 lung cancer treated by complete resection do not die of that disease. The overall five-year survival of patients enrolled in this program who developed lung cancer is 35%, in contrast to 13% for lung cancer in the United States as a whole. Survival at 10 years for all lung cancer patients in this screening program is 25%, and for those with Stage 1 lung cancer it is approximately 65%. 5.(ABSTRACT TRUNCATED AT 250 WORDS)
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Recent trends in lung cancer mortality in Switzerland and the distribution of this cancer by districts, linguistic regions, and occupations are described. In 1985 7.5% of male deaths were due to the disease; female lung cancer is increasing (male-female ratio of deaths 1985: 5.9;in the age-class 35-44: 1.5). ⋯ The geographic distribution shows a correlation with population density (chiefly in the over 65 age group) and there were high rates in agglomerations such as Basle and in some peripheral regions. The impact of smoking and occupational/environmental factors on the distribution of lung cancer by regions and occupations is discussed.