The Hazard of Bronchogenic Carcinoma and Its Prevention

Our plain-English summary of The Hazard of Bronchogenic Carcinoma and Its Prevention, by A. Ochsner (1963).

The study

• Author: A. Ochsner
• Published: Military Medicine 128(12):1167-1172 December (1963)
• 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 1963 article by Alton Ochsner, of the Department of Surgery at the Ochsner Clinic in New Orleans, was a commentary and review on lung cancer (bronchogenic carcinoma) and cigarette smoking, written for military physicians. It does not mention asbestos. The article mainly reviewed existing evidence rather than describing a new study in detail. It did report that experiments by the author's own group had found that filters removed an almost negligible amount of tar residue, without saying whether these results were new. The evidence reviewed included national death statistics, the American Cancer Society study by Hammond and Horn of slightly fewer than 200,000 men, and Doll and Hill's study of British physicians. It also included autopsy examinations of airway tissue by Auerbach and colleagues and animal skin-painting experiments with cigarette tar by Wyndner and colleagues. The cited studies reported that lung cancer death rates rose with the amount smoked and fell the longer people had stopped smoking. The author concluded that, except possibly for adenocarcinoma, total abstinence from smoking was the only sure way to prevent bronchogenic carcinoma, and urged military physicians to stress this.

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: Commentary and narrative review of published studies and statistics. It also briefly mentions filter experiments by the author's own group, without methods or figures.
• Who was studied: No study population described for the author's own work. The article discussed other researchers' studies, including the American Cancer Society study of slightly fewer than 200,000 men aged 50 to 70 years and the study of British physicians by Doll and Hill.
• Exposure: Cigarette smoking (also pipe and cigar smoking in the cited studies). Asbestos is not discussed.
• Main results:
  • Citing U.S. Public Health statistics, the article reported that bronchogenic cancer made up 1.1 per cent of all cancer deaths in the United States in 1920, 2.2 per cent in 1930, and 15 per cent in 1960.
  • Citing the American Cancer Society study by Hammond and Horn, the lung cancer death rate was 3.4 per 100,000 in non-smokers. Among men who had smoked less than a package a day, it was 57.6 in those who continued smoking, 35.5 in those who had stopped for less than 10 years, and 8.3 in those who had stopped for more than 10 years.
  • Citing Doll and Hill's study of British physicians, the bronchogenic cancer death rate per 100,000 was 7 in non-smokers, 38 in pipe smokers, 68 in pipe and cigarette smokers, and 125 in cigarette smokers.
  • The author stated that experiments by the author's own group measuring tar in cigarettes found that filters removed an almost negligible amount of residue. No figures or methods were given, and the article does not say whether these results were new or previously published.
• The authors' conclusion: The author concluded that, with the possible exception of the rare adenocarcinoma, total abstinence from smoking was the only sure way of preventing bronchogenic carcinoma. The author also concluded that military physicians had a particular opportunity and obligation to emphasize the harmful effects of smoking.
• Limitations the authors state:
  • The author stated that whether changes in the bronchial lining reverse after a person stops smoking could only be definitely determined by repeated bronchoscopy of heavy smokers, which was hardly feasible.

Topics

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

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