Abstract
BackgroundHistological classification of lung cancer is essential for investigations of carcinogenesis and treatment selection. We examined the temporal changes of lung cancer histological subtypes.MethodsLung cancer cases diagnosed in the Life Span Study cohort between 1958 and 1999 were collected from tumor registries (TR), mainly consisting of population-based cancer registries. A total of 1,025 cases were histologically reviewed according to the World Health Organization 2004 Classification by a panel of pathologists (PP). Sensitivity and specificity of diagnoses in TR were calculated, assuming that the diagnosis by PP was the gold standard.ResultsSensitivity and specificity were 0.91 and 0.92 for adenocarcinoma (AD), respectively, and 0.92 and 0.94, respectively, for squamous cell carcinoma (SQ). They were similar for AD and SQ throughout the observation period. For small cell carcinoma (SM), sensitivity was low until about 1980 (0.47 in 1958–1969, and 0.61 in 1970–1979) and then became higher thereafter (0.98 in 1980–1989, and 0.95 in 1990–1999), whereas specificity was high during the whole period (range 0.99 to 1.00). Among 45 cases that were not reported as SM in TR but diagnosed as SM by PP, 16 cases were recorded as undifferentiated carcinoma in TR.ConclusionDiagnosis of AD and SQ of lung cancer were generally consistent between TR records and PP review, but SMs tended to be coded as other histological types until the 1970s.
Highlights
Lung cancer has been the most common cancer worldwide for several decades.[1]
Forty-four cases that were not recorded as AD in the tumor registries (TR), but diagnosed as AD by the panel of pathologists (PP), included 13 cases of large cell carcinoma not otherwise specified (NOS), and 12 cases of squamous cell carcinoma NOS in the TR
46 AD cases with TR+ and PP− included 10 cases of adenosquamous carcinoma, and 9 cases of large cell carcinoma diagnosed by the PP
Summary
Lung cancer has been the most common cancer worldwide for several decades.[1]. In Japan, lung cancer mortality increased after World War II and is currently the leading cause of death from cancer. Rates have decreased in males since the late 1990s but have remained relatively stable in females.[2] Histological classification is essential for pathological investigation of carcinogenesis and has recently become critical for the selection of treatment methods based on different sensitivities to chemotherapy and radiotherapy by subtype of lung cancer.[3] Several studies indicated high inter-observer agreement of histological diagnoses and high reproducibility of histological types reported to cancer registries in independent review.[4,5,6] We believe that it is important from the viewpoint of descriptive epidemiology to show a long-term trend in histological subtypes of lung cancer based on the current diagnostic criteria. Histological classification of lung cancer is essential for investigations of carcinogenesis and treatment selection. We examined the temporal changes of lung cancer histological subtypes
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