Pulmonary Carcinoma: Pathogenesis, Diagnosis, and Treatment

Our plain-English summary of Pulmonary Carcinoma: Pathogenesis, Diagnosis, and Treatment, by Edgar Mayer, Herbert C. Maier (1956).

The study

• Authors: Edgar Mayer, Herbert C. Maier
• Published: New York University Press, New York (distributed by J. B. Lippincott Company, Philadelphia) (1956)
• Type of article: Book excerpt
• 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 is a chapter by E. Cuyler Hammond and Willard Machle in a lung cancer textbook edited by Edgar Mayer and Herbert C. Maier. It was mainly a review. Apart from the authors' own unpublished observations of beryllium workers, it reported no new study. They discussed evidence on three kinds of inhaled substances: workplace dusts, vapors and gases, general air pollution, and tobacco smoking. On asbestos, they noted that lung cancer arising in people with asbestosis had been reported. One author (Gloyne) judged the association significant and causal; another found no carcinoma in a Finnish study of asbestosis. The authors wrote that the medical literature up to 1955 referred to approximately sixty cases of asbestosis and lung cancer in the same patient (the scanned number is damaged). In their view there were too few cases and too little epidemiologic data to establish a significant relationship, and differing exposures around the world complicated interpretation. The authors concluded that the data were suggestive but that inferring a causal relationship was not warranted. They counted asbestos among suspected agents whose causal role, in their opinion, rested on insufficient evidence.

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: Review chapter in a textbook, summarizing published epidemiologic and experimental evidence on environmental and occupational causes of lung cancer. It also includes a brief mention of the authors' own unpublished observations of beryllium workers. It contains no original study of asbestos
• Who was studied: No asbestos study population of its own. The chapter reviewed published reports, including medical literature up to 1955 on lung cancer in people with asbestosis. Separately, the authors cited their own unpublished observations of workers exposed to beryllium since 1939
• Exposure: Inhaled agents: occupational exposures (uranium, chromates, nickel, arsenic, beryllium and other metals, pneumoconiosis-producing dusts including asbestos, organic compounds), general air pollution, and tobacco smoke. Asbestos is discussed as asbestosis in relation to lung cancer; no fiber types are named
• Main results:
  • Reviewed reports on asbestosis and lung cancer disagreed. One author (Gloyne) believed the association significant and causal; another found no carcinoma in a study of asbestosis in Finland
  • Lung cancer had been reported at autopsy in lungs with asbestosis. In the authors' view there were too few cases and too little epidemiologic data to establish a significant relationship
  • The medical literature up to 1955 contained references to approximately sixty cases of asbestosis and lung cancer coexisting in the same patient. The number is damaged in the scan and is printed as 'sivey'
  • The authors' own unpublished observations of workers exposed to beryllium since 1939 had not revealed a single case of bronchogenic carcinoma. The man-years figure is garbled in the scan
  • The reviewed studies (Vorwald and others) agreed that pneumoconiosis in general, and silicosis in particular, did not involve any predisposition to lung cancer
• The authors' conclusion: The authors concluded that the data on asbestosis and lung cancer were suggestive but that inference as to a causal relationship was not warranted. They listed asbestos, with beryllium and other pneumoconiosis-producing agents, among substances suspected of causing lung cancer in industrial workers whose causal role they considered insufficiently supported
• Limitations the authors state:
  • The authors stated that interpretation of the asbestos associations was complicated by differing compositions, associated materials and conditions of exposure in different parts of the world
  • The authors stated that inducing a tumor in a mouse carries little weight in estimating whether a material causes cancer in humans

Topics

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

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