SMOKING and bronchogenic carcinoma.

Abstract

HomeRadiologyVol. 56, No. 1 PreviousNext EditorialSmoking and Bronchogenic CarcinomaPublished Online:Jan 1 1951https://doi.org/10.1148/56.1.116MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In AbstractBronchogenic carcinoma as a cause of death has shown a progressive increase during the past several decades. Many theories have been advanced to account for this remarkable change in the vital statistics. Prolongation of the life span must be accorded some consideration, although the incidence of bronchogenic carcinoma has risen relatively more than that of cancer as a whole. The inhalation of gas engine exhaust fumes has been blamed by some, and occupational hazards may play a role. A number of recent studies have indicted tobacco smoking as a possible etiologic factor, and statistical studies strongly support this theory.Wynder and Graham have made a study of 684 cases of proved bronchogenic carcinoma. In 605 of these (in men) they found that over 50 per cent of the patients were excessive or chain smokers compared to 19 per cent of a general hospital group without cancer. Only 2 per cent of the lesions occurred in non-smokers or minimal smokers. In 96 per cent of the carcinoma series there was a history of smoking for over twenty years, which may account for the greater incidence of the disease in men, as excessive smoking by women is of relatively recent development. Wynder and Graham believe that there may be a lag period of ten years or more, even after cessation of smoking, before the development of the neoplasm. A very high percentage (94.1 per cent) of the patients smoked cigarettes, and it is believed that the practice of inhalation among cigarette smokers may be of significance.In a similar study, Doll and Hill reported their observations in 709 cases of carcinoma of the lung from twenty London hospitals. Of the men in this series 0.3 per cent and of the women 31.7 per cent were non-smokers. Among control non-cancer groups, the figure for men was 4.2 per cent and for women 53.3 per cent. Of the smokers with carcinoma of the lung, a high proportion were in the “heavy smoking” category ; 26 per cent of the male patients and 14.6 per cent of the female carcinoma patients smoked the equivalent of 25 cigarettes per day, while only 13.5 per cent of the male and none of the female non-cancer control patients smoked as much. Cigarette smoking was found to be more closely related to carcinoma of the lung than pipe smoking.Levin, Goldstein, and Gerhardt studied the smoking habits of patients with cancer involving both the lung and lip. Their data indicate that cancer of the lung occurs more than twice as frequently among those who have smoked cigarettes for twenty-five years than among non-smokers of comparable age.The offending agent is not indicated from any of these studies, as distillates from tobacco have never been proved to be carcinogenic. Doll and Hill suggest that some other agent, such as spray material on tobacco plants, may be responsible.Article HistoryPublished in print: Jan 1951 FiguresReferencesRelatedDetailsRecommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 56, No. 1 Metrics Altmetric Score PDF download