The duration of carcinoma of the lung.

Considered a rare disease 30 years ago, carcinoma of the lung is today recognized as one of the common causes of death in Individuals after the age of 40. It has been estimated that 10 per cent of all cancers occur in the tracheobronchial tree; by some authorities the respiratory tract is considered to be the third most common location for a fatal tumor. Because of its protean nature cancer of the lung must be treated as an aggregate, rather than as an individual problem, if statistical validity is to be attained. In 1912, Adler3 had an international collection of 374 known cases of carcinoma of the lung. Today series of thousands of cases are reportable and, in March of 1951, 624 lung cancers studied by the joint efforts of the Consultation Clinic of the Brompton and Royal Cancer Hospital in the five years from 1944 to 1948 were reported.5 One year later, Ochsner, DeCamp, DeBakey and Ray22 were able to report the details of 948 patients with bronchogenic carcinoma which they had personally observed. Today “cancer of the lung is the most frequent visceral cancer of the male patient,” (Wynder and Graham, 1950 ). Overholt predicts that present practicing physicians alone will contribute 3,500 lung cancers to this rapidly growing list.23 A recent report from England and Wales shows that there were 15 times as many deaths reported from bronchogenic carcinoma in 1947 as in 1922. It is a natural reaction to question not only the reasons for this increase in international prominence but also its actual existence. Many authorities have suggested that the rising incidence was more apparent than real, or that it was a relative increase associated with the aging of our population. It is true that more people are reaching the visceral cancer age, but some other reason must be found to explain the elevation of lung cancer in men from eighth to first or second place.’3 It would be heretical to suggest that the master pathologists of the last century failed to recognize this tumor and it would be a derogation to suggest that our pathologists today recognize it only because of the notoriety brought to it by the radiologists and surgeons. The increase would seem to be real. The correlation of the increase in bronchogenic carcinoma with the increase in the use of tobacco as indicated by Wynder and Graham,33 Ochsner, et al.22 and others may or may not be valid but the increase in incidence is certainly true. Bronchogenic carcinoma works stealthily for a portion of its life but