Early Recognition of Bronchogenic Carcinoma

Our plain-English summary of Early Recognition of Bronchogenic Carcinoma, by A. Ochsner.

The study

• Author: A. Ochsner
• Published: Postgraduate Medicine p214-220
• 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 was presented at a postgraduate medical assembly. In it the author gave a clinical overview of bronchogenic carcinoma (lung cancer), drawing on cases treated at the Ochsner Clinic in New Orleans. It does not mention asbestos. The author believed the rising lung cancer rate was due to cigarette smoking, pointing to a parallel between cigarette sales and cancer incidence. Among men in the series, 57 per cent of tumors were epidermoid, 28 undifferentiated and 15 per cent adenocarcinoma. A positive diagnosis was made before the chest was opened in 80 per cent of cases, and chest X-ray gave a positive diagnosis in 83 per cent. The average delay before diagnosis was 9.3 months for private patients and 7.5 months for charity patients. For the whole group, the delay attributed to physicians (5.5 months) was longer than the delay attributed to patients (2.8 months). Of 317 patients whose tumors were not removed, none lived longer than four years and only 1 lived that long. The author urged regular chest X-rays for older men who were heavy smokers.

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: Clinical overview presented as a lecture, drawing on the author's clinic case series; not a formal study
• Who was studied: Patients with bronchogenic carcinoma at the Ochsner Clinic, New Orleans. The total is printed as 1122 in a figure label and as 1,022 in the text. Resected cases are given as 371 or 372 in figure labels.
• Exposure: No asbestos exposure was discussed. The author attributed the increase in lung cancer to cigarette smoking.
• Main results:
  • Among men in the series, 57 per cent had epidermoid carcinoma, 28 undifferentiated and 15 per cent adenocarcinoma
  • A positive diagnosis was made before the chest was opened in 80 per cent of cases
  • Chest X-ray (roentgenologic) diagnosis was positive in 83 per cent of cases
  • Average delay before diagnosis was 9.3 months in private cases and 7.5 months in charity cases
  • For the entire group, patient delay was 2.8 months and physician delay 5.5 months. For private cases it was 2.6 months patient delay and 6.2 months physician delay.
  • Time from first symptoms to definitive therapy was 7.5 months in nonresected cases and 10.5 months in resected cases. The scan prints 105; the text confirms the difference was about three months.
  • Hospital deaths numbered 76, most of them cardiovascular
  • Of 317 patients in the nonresected group, none lived longer than four years and only 1 lived that long
• The authors' conclusion: The author concluded that the increase in lung cancer is probably due to cigarette smoking, that diagnosis is usually long delayed, and that older men who are heavy smokers should have chest X-rays every three to six months.

Topics

Medical terms in this study, explained in our Lexicon: Bronchogenic Carcinoma, Lung Cancer, Adenocarcinoma, Chest X-Ray.

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