Appearance of First Roentgenographic Abnormalities Due to Lung Cancer

Abstract

To study the natural history of lung cancer, 6,137 men aged 45 years or more were followed by semiannual photofluorograms and symptom questionnaires for eight to ten years. Seventy-six histologically confirmed carcinomas developed during this period. In 45 cases the lung cancer appeared within nine months of a normal film so that the first radiological appearance of the tumor could be characterized; 27 arose peripherally and 9 as solitary nodules. More than half of the 76 cancers arose in men whose earlier films revealed abnormalities of the lungs or pleurae. Pulmonary fibrosis preceded the x-ray evidence of cancer in 24% of the cancer patients, all of whom smoked; fibrosis was present in 24% of a matched sample of smokers without cancer, and in only 13% of a matched sample of nonsmokers.