Cancer of the Lung: A Preventable Disease

Our plain-English summary of Cancer of the Lung: A Preventable Disease, by A. Ochsner (1973).

The study

• Author: A. Ochsner
• Published: Journal of the American Dietetic Association, Volume 63 No.3, March 1973.
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This article is the printed version of a talk the author gave to the American Dietetic Association in October 1972. It is a narrative review of published evidence that smoking, especially cigarette smoking, causes lung cancer. It reports no new study of its own and does not mention asbestos. The author recalled seeing nine lung cancer cases within six months in 1936, all in men who smoked heavily. The article cites an American Cancer Society prospective study of about 200,000 men aged fifty to seventy. That study reported lung cancer rates, excluding adenocarcinoma, of 3.4 per 100,000 in non-smokers and 78.6 in cigarette smokers. Rates rose with the amount smoked, to 217.3 in men smoking more than two packs a day, and fell the longer former smokers had stopped. The article also describes autopsy studies by Auerbach and associates that linked bronchial cell changes to the amount smoked. It describes animal experiments in which cigarette tar painted on skin produced cancers in 44 per cent of the animals after two years. The author concluded that lung cancer is largely preventable by not smoking and that few cases are curable.

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: Narrative review of published studies and statistics on smoking and lung cancer, presented as a talk at a professional meeting; no original study
• Who was studied: No study population of its own. The author summarized other studies, including an American Cancer Society prospective study of approximately 200,000 men aged fifty to seventy in the United States, studies of British doctors, and data from Iceland, Great Britain, Israel, Warsaw and Los Angeles
• Exposure: Tobacco smoking (cigarettes, cigars and pipes), including amount smoked, age at starting and time since stopping. Asbestos is not discussed
• Main results:
  • The author recalled seeing nine cases of lung cancer within six months in 1936 at Charity Hospital in New Orleans; all were men who smoked heavily
  • Citing U.S. figures, the article states that from 1950-1952 to 1965-1967 lung cancer in men increased 106 per cent (19.7 to 40.6 per 100,000 population)
  • In the American Cancer Society prospective study, lung cancer incidence excluding adenocarcinoma was 3.4 per 100,000 population in non-smokers, 78.6 in cigarette smokers, 11.4 in cigar smokers and 28.9 in pipe smokers
  • In the same study, incidence rose with amount smoked: 51.4 for less than a half pack a day, 59.3 for a half pack to a pack, 143.9 for one to two packs, and 217.3 for more than two packs
  • In the same study, among men who had smoked less than a pack a day, incidence was 57.6 in those who kept smoking, 35.5 in those who had stopped less than ten years, and 8.3 in those who had stopped more than ten years
  • Doll and Hill reported that from 1953-1957 through 1961-1965, lung cancer death rates increased 7 per cent among all British males but fell 38 per cent among British doctors, half of whom had stopped smoking
  • In autopsy studies by Auerbach and associates, carcinoma in situ was found in none of the non-smokers or occasional smokers and in 11.4 per cent of those who smoked more than two packs a day
  • In animal experiments by Wynder and associates, cigarette smoke tar applied to the skin produced cancers at the application site in 44 per cent of animals after two years; solvent-only controls developed no tumors
  • In a Los Angeles study of Seventh Day Adventists, who do not smoke, only one developed lung cancer, and he had been a heavy smoker before converting
• The authors' conclusion: The author concluded that lung cancer, apart from adenocarcinoma (about 5 per cent of cases), is caused by smoking and is therefore largely preventable. Once it develops, the author stated, the chance of cure is less than 10 per cent, usually 5 per cent

Topics

Medical terms in this study, explained in our Lexicon: Lung Cancer, Adenocarcinoma, Autopsy.

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