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Query: UMLS:C0242379 (lung cancer)
 71,905 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a prospective study of 6,027 older men screened every six months for ten years by means of chest photofluorograms and questionnaires regarding symptoms, 121 developed lung cancer after the first examination. Eighty-five men with lung cancer had the opportunity to be screened eight times before the tumor was detected by chest x-ray film, but only 33 actually reported that often. These 33 men were compared with matched controls for symptoms before the neoplasm was detected radiologically. The common symptoms of expectoration and chronic cough showed a significant increase in frequency over time in the cases of cancer, while only expectoration showed a slight increase in the controls. Uncommon symptoms more suggestive of lung cancer (hemoptysis and worsening cough) occurred in only four men prior to detection of cancer. Symptoms are seldom useful in the detection of occult lung cancer, but the appearance of expectoration and chronic cough in older male smokers should raise a suspicion of this disease.
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PMID:The Philadelphia Pulmonary Neoplasm Research Project. Symptoms in occult lung cancer. 62 May 58

The case histories of 474 patients with lung cancer were screened. Chronic bronchitis was assumed to precede lung cancer if chronic cough and sputum had been present for more than five years. Daily consumption of cigarettes, cigars (= 5 cigarettes) or pipes (= 1 cigarette) and the number of pack-years were noted. FEV1 in percent of the slowly inspired vital capacity (FEV1 %VC) was regarded as a sensitive index for the degree of bronchial obstruction. Group 1 included 221 lung cancer patients with a clear history of preexisting chronic bronchitis. Group 2 included 175 cases without such history. Heavy smokers and severely obstructed patients were found more often in group 1 than in group 2 (p less than 0.0005). A lack of correlation was evident between smoking habits and FEV1 %VC when group 1 was fused with group 2: r= -0.071, p greater than 0.20. Indeed, light, heavy, and very heavy smokers were evenly distributed in group 1 among severely and slightly obstructed patients. However, in group 2 heavy and very heavy smokers were found more frequently in patients with slight bronchial obstruction than in patients with severe bronchial obstruction (p less than 0.01). It appears that an important subgroup of heavy and very heavy smokers with lung cancer are protected from chronic bronchitis as well as from bronchial obstruction. The reasons for this protection are not clear.
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PMID:[Smoking, chronic bronchitis, bronchiolar obstruction and bronchial carcinoma]. 64 73

Beginning in 1963 a 10-year prospective study of 125 chemical workers was carried out by periodic screening for five years and follow-up for an additional five years. Eighty-eight men were exposed to chloromethyl ethers in varying cumulative doses estimates by retrospective rating. They were divided into three groups by degree of exposure. Age distribution was similar in all groups but the proportion of current heavy cigarette smokers at the start of observation decreased with increasing chemical exposure. The prevalence of chronic cough showed a dose-response relationship to both smoking and chemical exposure. The end-expiratory flow rate was below 60% of predicted in about one-third of the exposed men compared to only 6% of unexposed men and the frequency of such low rates was dose-related to cigarette smoking. During the five-year periodic screening study the prevalence of chronic cough decreased and the prevalence of dyspnea increased while chemical exposure was falling. The 10-year incidence of lung cancer was dose-related to chemical exposure but inversely related to smoking habits. All cancers were small-cell carcinomas, occurred in men younger than 55, and had an induction-latent period of 10 to 24 years. The 10-year mortality rate in this group of workers was 2.7 times expected and lung cancer accounted for the excess number of deaths.
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PMID:Chloromethyl ethers, cigarettes, cough and cancer. 125 81

Body mass index (weight/height2) was studied for its prediction of lung cancer in Finnish men examined by the Social Insurance Institution's Mobile Clinic and followed up by the Finnish Cancer Registry. Among 25,994 participants aged 20 to 75 years and free from cancer at the start of the study, 504 lung-cancer cases were diagnosed during a maximum follow-up of 19 years. There was a significant inverse gradient between body mass index and the incidence of lung cancer. This association was not due to confounding by age, smoking, social class, self-perceived general health, history of stress symptoms, chronic cough or chest X-ray findings, although these factors correlated with body mass index and were also significantly predictive of lung cancer. After adjustment for these factors, the relative risks of lung cancer were 1.0, 1.4, 1.5 and 1.8 (p for trend less than 0.001) from the highest to the lowest quartiles of body mass index. The association was noted among current smokers, but it was most obvious among men who had never smoked, the relative risk of lung cancer between the lowest and highest quartiles of body mass index being 7.6 (95% confidence interval = 2.0 to 29.4). The inverse gradient persisted throughout the entire follow-up period, and was most distinct after the first 10 years of follow-up, the relative risks for the quartiles of body mass index being 1.0, 1.9, 2.3 and 2.6 (p less than 0.001). The present study shows that the thinner the man, the more liable he is to develop lung cancer. Leanness or some factor or cluster of factors closely correlated to it, may play an aetiological role in lung cancer.
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PMID:Leanness and lung-cancer risk. 187 66

Long term passive exposure to tobacco smoke can be a cause of disease in sensitive non smokers, particularly in children of smoking mothers, who may suffer more frequently from respiratory tract infection, otitis media and chronic cough as well as exacerbation of pre-existent asthma. In adults, the relationship is less obvious. A slight but significant alteration of lung function has been observed. The increase in the incidence of lung cancer in non-smoking spouses (men and women) of smokers can be regarded as proven.
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PMID:[Passive smoking]. 204 28

Numerous studies have documented the effects of smoking and reduced pulmonary function on all-cause mortality. The effects of respiratory symptoms are less well studied. This paper examines the joint effects of respiratory symptoms, lung function, and smoking using 11-year mortality data on 698 subjects aged 25 years and older. Copies of death certificates were obtained for all 120 confirmed deaths, and cause of death was coded by a nosologist using the rules of the International Classification of Diseases, Ninth Revision. Symptoms of cough/phlegm, wheeze, and dyspnea were significantly associated with all-cause mortality in separate univariate analyses. On a cause-specific basis, these associations appeared to hold for chronic obstructive pulmonary disease, lung cancer, and vascular disease. Further analysis indicated that, for both smokers and nonsmokers, the presence of chronic cough and/or sputum production was related to mortality only in the presence of wheezing. In addition, among smokers, the presence of both cough/phlegm and wheeze. In addition, among smokers, the presence of both cough/phlegm and wheeze was significantly associated with mortality only among subjects with low initial lung function. Although the limited number of deaths and the nonrandom nature of the cohort limit the generalizability of our findings, it seems clear, based on these results and other published studies, that symptoms of cough, phlegm, and/or wheeze have important adverse health implications even in the absence of smoking and reduced lung function. More studies using common methodological approaches are needed.
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PMID:Respiratory symptoms, lung function, and mortality in a screening center cohort. 272 54

Autopsy studies have shown that lung cancer is often not detected during life and that a correct antemortem diagnosis is made preferentially in patients with pulmonary symptoms, in smokers, and in men. The current research was done as a case-control study to determine whether the autopsy suggestions of detection bias in diagnostic pursuit of lung cancer were confirmed by the way that sputum Papanicolaou smears (Pap smears) were ordered in an inpatient setting. The cases were 385 hospitalized patients in whom sputum Pap tests had been newly performed from October 1977 to September 1980. Each case was matched by age, admission date, and admission diagnosis to a control patient who had not received a Pap test. Excluded from the study were patients in whom sputum Pap tests were obligatory (e.g., those with manifestations of hemoptysis) or unnecessary (e.g., those with a previous diagnosis of lung cancer or multiple previous sputum Pap tests). Demographic data, amount and duration of cigarette smoking, and details of clinical manifestations were extracted from the patients' medical records by research assistants blind to the study hypothesis. Compared with controls, the cases had distinctive elevations in odds ratios for chronic cough, recent cough, male sex, and cigarette smoking, which also showed a distinctive dose-response relation. In multivariate analyses, all four of these "risk factors" for selective ordering of a sputum Pap smear remained independently highly significant. In the extreme category, men who smoked and coughed were 22 times more likely to have a sputum Pap test ordered than were nonsmoking women who did not cough. Clinically, the results suggest that women and nonsmokers may be deprived of appropriate diagnosis and therapy unless a diagnostic workup for lung cancer is guided mainly by radiographic findings and presenting manifestations. Statistically, detection bias has probably led to an excessively elevated magnitude for the cigarette smoking-lung cancer association and to a falsely low estimate of incidence rates in women.
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PMID:Detection bias in the diagnostic pursuit of lung cancer. 318 78

Previous epidemiologic studies have associated symptoms of chronic bronchitis and other respiratory diseases with the risk for lung cancer. To assess the possible precursor or premonitory role of these conditions for lung cancer among nonsmokers, a comparison of the prevalence rates of these conditions in 2 urban industrialized communities (Hong Kong and a Tokyo suburb) with a 300% difference in female lung cancer incidence rates was conducted. A community survey of 314 nonsmoking mothers and their children in Hong Kong, and 243 mothers and children in Japan showed that the prevalence of reported chronic cough and sputum symptoms was 10 or more times higher in Hong Kong than in Japan. The disparity in the rates of respiratory diseases/symptoms was most apparent in the comparison of children. Occupational exposure to dust or fumes and larger household sizes were found to be associated with higher levels of respiratory illnesses among the Hong Kong mothers. The much higher prevalence rates of respiratory symptoms among Hong Kong than among Japanese subjects correlated with each community's female lung cancer incidence rates of 27.1 versus 8.1/100,000, respectively.
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PMID:A comparison of the prevalence of respiratory illnesses among nonsmoking mothers and their children in Japan and Hong Kong. 319 28

Despite much research and clinical application of various treatment modalities, the five-year survival rate in bronchogenic carcinoma is very poor. With over 90,000 lung cancer deaths recorded in 1977, and over 100,000 deaths estimated in 1980, we should emphasize prevention as well as cure in our daily patient contacts. Patients particularly at high risk are (a) men over 45 years of age with more than 10 pack-years of smoking, (b) patients (men and women) with chronic cough, recent pneumonia, or hemoptysis. (c) Patients with a stable solitary nodule, (d) patients with occupational exposure. Hopefully, with prevention, early diagnosis, and improved treatment, our role in management of the lung cancer patient will be easier. Management of the patient with bronchogenic carcinoma will follow in the second part of this article.
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PMID:Part 1. Bronchogenic carcinoma a review and study. 700 29

A community-based study has been reviewed to assess whether impaired forced expiratory volume in 1 s (FEV1) and/or the symptoms of chronic cough and sputum production predict the incidence of lung cancer, after controlling for age, sex, cigarette smoking history, and the dietary intake of carotenoids and retinoids. A cohort of 2099 women and 1857 men, 25 years of age or older, were first examined from 1962 to 1965. As of 1987, there were 60 validated lung cancers diagnosed in men (1.83 per 1000 person-years) and 17 in women (0.39 per 1000 person-years). The incidence density of lung cancer in current smokers at baseline, when compared with never smokers, was increased 5.34 (95% confidence interval, 1.74, 16.38) times in women and 4.11 (95% confidence interval, 1.63, 10.34) times in men. The risk of lung cancer increased in women and men in relation to the average daily intensity of exposure in current smokers and the duration of smoking history (< 20 years, > or = 20 years) in current and ex-smokers. When stratified by cigarette smoking intensity, subjects with chronic cough and phlegm experienced a future risk of lung cancer that was more than 3 times higher than that in the nonsymptomatic subgroup. Among the smoking women and men at entry, those in the lowest quartile of the percent predicted FEV1, after controlling for the average number of cigarettes smoked per day, experienced a risk of lung cancer that was 2.7 times that of subjects in the highest quartile. With each 10% decrease in percent predicted FEV1, the risk of lung cancer increased 1.17 times (0.96, 1.42), after controlling for age, sex, and cigarette smoking intensity at baseline. The average annual decline in FEV1 as estimated between 1962 and 1965 and 1967 and 1969 was a significant independent predictor of future lung cancer incidence after controlling for cigarette smoking history; the slope of the regression line indicated that with each decline in FEV1 of 100 ml/year, lung cancer incidence density increased 1.16 per 1000 person-years (95% confidence interval, 0.30, 2.01). Controlling for potential confounding by quartile distribution of calorie-adjusted dietary intake of vitamin A, beta-carotene, cholesterol, and fat did not weaken or alter the fundamental relationship with impaired pulmonary function. Rapidly declining ventilatory function in conjunction with persistent symptoms of chronic bronchitis in current smokers is predictive of the increased risk of lung cancer and correlates with cumulative levels of exposure to cigarette smoking.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Declining FEV1 and chronic productive cough in cigarette smokers: a 25-year prospective study of lung cancer incidence in Tecumseh, Michigan. 806 76


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