Cancer of the larynx and lung in three urban counties in South Carolina

Our plain-English summary of Cancer of the larynx and lung in three urban counties in South Carolina, by J.C. Caston, J.F. Finklea, S.H. Sandifer (Southern Medical Journal, 1972).

The study

• Authors: J.C. Caston, J.F. Finklea, S.H. Sandifer
• Journal: Southern Medical Journal
• Published: 1972;65(6):753-6
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 002421).

In plain English

This study used death certificates to examine larynx and lung cancer deaths in three urban South Carolina counties: Charleston, Greenville and Richland. It used 1,234 certified deaths from 1958 to 1967 to calculate combined lung and laryngeal cancer death rates per 100,000 people per year. Smoking and occupation were not studied because death certificates lacked that information. Charleston County's total rate of 48.7 was significantly higher than the rates for Greenville (37.5) and Richland, which were similar to each other. The Richland figure is garbled in the scanned text. Among sex and race groups, only Charleston's white men had a significantly higher rate. The authors then divided Charleston County into heavy and light suspended particulate pollution areas. White women in the heavily polluted area had a significantly higher rate, roughly twice that of white women in the lighter area and the other two counties. Other groups did not differ significantly. No asbestos-specific measurements were reported. The authors named asbestos emissions as one possible airborne source, along with chromates, sulfuric acid mists and polycyclic aromatic hydrocarbons. They wrote that they did not intend to suggest that air pollution alone causes lung cancer.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Descriptive epidemiologic comparison of death-certificate mortality rates between counties, and between heavy and light air-pollution areas within one county
• Who was studied: 1,234 certified deaths from lung and laryngeal cancer, counted by place of residence, in Charleston, Greenville and Richland counties, South Carolina, 1958 to 1967. Population figures came from the 1960 census.
• Exposure: Area of residence, and suspended particulate air pollution within Charleston County (heavy versus light particulate areas). Smoking and occupation were not studied. No asbestos-specific measurements were reported; asbestos is mentioned only in the discussion as a possible source of airborne exposure in Charleston County.
• Main results:
  • The total lung and laryngeal cancer death rate for Charleston County (48.7 per 100,000 per year) was significantly higher than the rates for Greenville (37.5) and Richland counties, which were similar to each other. The Richland rate is printed as "358" in the scanned text; the decimal point appears to have been lost, but the exact value cannot be confirmed from the article.
  • In Charleston County, rates for both men and women were higher than in the other counties, but only the male rate was significantly increased.
  • By sex and race, Charleston exceeded the other counties in every group except nonwhite men. The white male rate was the only group that was significantly higher.
  • Charleston had the highest rates in each age group. In one middle age group (printed "45 to 31" in the scanned text), the Charleston rate was significantly increased and about twice the rate in Greenville and Richland counties.
  • Within Charleston County, rates for white men, nonwhite men and nonwhite women did not differ significantly between the heavy and light particulate areas.
  • White women in Charleston's heavily polluted area had a significantly higher rate than white women in the less polluted area and than white women in Greenville or Richland counties, approximately twice those rates.
• The authors' conclusion: The authors concluded that the higher rates among white women in heavily polluted areas were consistent with exposure to a carcinogen in the outdoor air. As possibilities in Charleston County they named asbestos emissions, chromate processing, sulfuric acid mists and polycyclic aromatic hydrocarbons produced at refineries. They stated that they did not intend to suggest that air pollution alone, or any other substance alone, causes lung cancer, and that further studies might find the excesses were due to specific occupations or to several airborne carcinogens.
• Limitations the authors state:
  • Smoking and occupational exposure were not studied because death certificates did not record smoking histories or occupational data.
  • Detailed pathologic classification of the lung cancers was not possible. Fewer than 10% of certified lung cancer deaths in Charleston County came to autopsy.
  • Nonwhite men were described as the most mobile group and therefore the least reliable for area comparisons.
  • The authors acknowledged inherent errors in the vital statistics system.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Throat and laryngeal cancer.

Medical terms in this study, explained in our Lexicon: Laryngeal Cancer.

Related studies

• Occupational cancer in Britain. Respiratory cancer sites: larynx, lung and mesothelioma — T. Brown, A. Darnton, et al. (2012)
• Alcohol, smoking, and occupational factors in cancer of the larynx: a case-control study — W. Ahrens, K.H. Jöckel, et al. (1991)
• Smoking and the occurrence of larynx cancer in Sweden - a population analysis — B. Järvholm, P. Liv, et al. (2026)
• Letter: Asbestos exposure and cancer of the larynx — T.L. Guidotti, J.L. Abraham, et al. (1975)
• Lung cancer mortality in North Carolina and South Carolina chrysotile asbestos textile workers — L. Elliott, D. Loomis, et al. (2012)
• Estimates of historical exposures by phase contrast and transmission electron microscopy for pooled exposure--response analyses of North Carolina and South Carolina, USA asbestos textile cohorts — J.M. Dement, D. Loomis, et al. (2011)

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