Changing Epidemiology of Lung Cancer

Our plain-English summary of Changing Epidemiology of Lung Cancer, by J.F. Beamis JR, A. Stein, J.L. Andrews JR (1975).

The study

• Authors: J.F. Beamis JR, A. Stein, J.L. Andrews JR
• Published: Medical Clinics of North America, Volume 39 No2. March 1975.
• 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 reviewed records of patients with lung cancer at the Lahey Clinic in the United States. The authors counted 1145 patients seen from 1957 to 1972 and examined the records of 231 women. Women's share of lung cancer patients rose from 13 per cent in 1957 to 1960 to 30 per cent in 1969 to 1972. Over the same periods the male to female ratio fell from 6.8/1 to 2.4/1, which the authors reported as statistically significant (P=0.01). Among the 201 women whose tumor type was known, the mix of cell types did not change significantly, and adenocarcinoma was the most common type (31 per cent). The share of women who had never smoked fell from 55 to 26 per cent. Among women whose smoking histories and tumor cell types were both known, smokers with Kreyberg group 1 (smoking-related) tumors were largely responsible for the increase. The authors concluded that their data suggest all cell types are related to cigarette smoking. Asbestos was not studied. The discussion only listed it among industrial agents linked to lung cancer. The authors noted that smoking histories may be inaccurate.

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: Retrospective review of clinic records and pathology specimens at a single clinic, combined with a discussion of national lung cancer trends
• Who was studied: 1145 patients with lung cancer seen at the Lahey Clinic Foundation (United States) from 1957 to 1972. The clinical records of 231 women with lung cancer were examined in detail, and pathology slides from 149 of them were re-examined. Tumor cell type was known for 201 of the women.
• Exposure: Cigarette smoking history, plus residence and occupation, among women with lung cancer. Asbestos was not studied. It was named only in the discussion as one of several industrial agents (with uranium, chromium, nickel, chloromethyl methyl ether and arsenic) that other research had associated with lung cancer.
• Main results:
  • Women made up a growing share of all lung cancer patients at the clinic: 13 per cent in 1957 to 1960 and 30 per cent in 1969 to 1972.
  • The male to female ratio among lung cancer patients fell from 6.8/1 (1957 to 1960) to 2.4/1 (1969 to 1972). The authors reported this change as statistically significant (P=0.01).
  • The 71 women with lung cancer seen in 1969 to 1972 were nearly double the number seen in 1957 to 1960.
  • Among the 201 women with known tumor histology, there was no significant change in cell type distribution over the years studied.
  • Among those 201 women, the most frequent types were adenocarcinoma (31 per cent), undifferentiated large cell cancer (22 per cent), epidermoid carcinoma (16 per cent) and undifferentiated small cell carcinoma (12 per cent).
  • Among women with lung cancer, the proportion who had never smoked fell from 55 per cent in 1957 to 1960 to 26 per cent in 1969 to 1972. Over the same periods the proportion of smokers rose from 40 to 49 per cent.
  • When only women with both known smoking histories and known cell types were analyzed (142 women in Table 6), smoking women with Kreyberg group 1 tumors were the group largely responsible for the recent increase in cases.
  • No specific high-risk occupations were identified among the women.
• The authors' conclusion: The authors concluded that their data suggest all lung cancer cell types are related to cigarette smoking. They believed the increase in women smokers since 1930 has been reflected in the recent rise in lung cancer in women.
• Limitations the authors state:
  • Smoking histories came from clinical records at diagnosis, so smokers may be undercounted. Some recorded nonsmokers could have been ex-smokers.
  • In two of the four-year periods, 25 per cent of the patients had unknown smoking histories.
  • Occupational histories were frequently missing from the clinical records.
  • The study was retrospective and not confined to a specific geographic population.

Topics

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

Browse return to medical research.