The changing pattern of lung carcinoma.
In a study of 505 cases of lung carcinoma from a period in which there was a significant change in tobacco-smoking habits, a dramatic shift in the histologic type and location of the lung tumors was observed. Peripheral tumors, found in 30.7% of the carcinomas occurring before 1978, were found in 42% of the carcinomas from 1986 to 1989. The corresponding decrease in the centrally originating bronchial carcinoma was from 69.3% to 57.3%. The greatest change in histologic cancer type was that the incidence of bronchioloalveolar carcinoma more than doubled from 9.3% in the earlier period to 20.3% percent in the 1986-to-1989 period. Corresponding to the decreasing incidence of lung carcinoma, there is a decrease in cancers related to cigarette smoking. A study of cases of lung carcinoma among nonsmokers and former smokers showed a decreased incidence of the bronchogenic cancers and an increase of cancer occurring in the peripheral lung parenchyma. This finding should be validated in other population-based studies, and if confirmed, new studies should be undertaken in an attempt to discover the factors that play a role in the development of such cancers. As an example, viral oncogenes may be a possibility. Viruses were suggested in the past as being related to the development of some of these tumor types.
Auerbach
O
O
Veterans Administration Hospital, East Orange, NJ 07019.
Garfinkel
L
L
D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology; D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000453:epidemiology / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001984:Bronchial Neoplasms / Q000453:epidemiology / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology / Q000473:pathology; D018288:Carcinoma, Small Cell / Q000453:epidemiology / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology; D002921:Cicatrix / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D008171:Lung Diseases / Q000453:epidemiology / Q000473:pathology; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D012907:Smoking / Q000453:epidemiology; D014481:United States / Q000453:epidemiology