Abstract
To study the natural history of lung cancer, 6,137 men aged 45 years or more were followed by semiannual photofluorograms and symptom questionnaires for eight to ten years. Seventy-six histologically confirmed carcinomas developed during this period. In 45 cases the lung cancer appeared within nine months of a normal film so that the first radiological appearance of the tumor could be characterized; 27 arose peripherally and 9 as solitary nodules. More than half of the 76 cancers arose in men whose earlier films revealed abnormalities of the lungs or pleurae. Pulmonary fibrosis preceded the x-ray evidence of cancer in 24% of the cancer patients, all of whom smoked; fibrosis was present in 24% of a matched sample of smokers without cancer, and in only 13% of a matched sample of nonsmokers.
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