NATURAL HISTORY OF LUNG CANCER

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Abstract
Symptoms preceded roentgenographic changes in four-fifths of the 67 men who developed "new" lung cancer while under observation for six months to ten years. More than half of the "new" cancers developed in men who had roentgenologic evidence of previous pulmonary or pleural disease, emphasizing the importance of careful follow-up observation of men with such findings. These data add clinical support to the pathologists'' concept of "scar cancer." Pleural symphysis may predispose to bronchogenic carcinoma by interfering with the bellows mechanism of the lungs and thus with the bronchial toilet, a situation which may be aggravated by the adverse effect of smoke on ciliary action. Study of a sample of smokers and a sample of nonsmokers matched to the cancer cases revealed that the smokers were so similar to the cancer cases in symptoms and roentgenographic abnormalities as to suggest that they were a homogeneous group, some of whom had latent and others manifest lung cancer.

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