Document 6R481EvQxo2p5KOjNMMog9bL4

FILE NAME Kent KNT DATE 1955 DOC KNT140 DOCUMENT DESCRIPTION Book Excerpt - Advances in Cancer Research Etiology of Lung Cancer - Table of Contents ADVANCESIN CANCER RESEARCH EDITED BY JESSE P. GREENSTEIN National Cancer Institute National Institutes of Health US Public Health Service Bethesda Maryland ALEXANDER HADDOW ChesteCr hester Beally Research Institute Royal Cancer Hospital London England Volume III ACADEMIC PRESS INC PUBLISHERS NEW YORK N.Y. 1955 The Institute . 270 . 274 278 282 . 283 . 288 315 . 323 327 339 Etiology of Lung Cancer RICHARD DOLL Statistical Research Unit of the Medical Research Council London School of Hygiene and Tropical Medicine Medicine London England Page Page Page Page I 2 5 OO 8 A. Retrospective Inquiries B. Prospective Inquiries 8 C. Method of Smoking D. Extent of Risk E. E. F. Consumption G. Identification of Carcinogenic Agent II Various Criticisms I. Conclusion A. Mortality in Town and Country B. Pollution of Town Air C. Differences in Urban D. Conclusion 4. Atmospheric Radioactivity 5. Previous Respiratory Infections Conclusion References I. INTRODUCTION 1. Conclusions of Louvain Symposium Knowledge of the causes of lung cancer was reviewed at tional symposium on the an interna- in Endemiology of Lung Cancer held at Louvain 1952 Council for International Organizations of MedicalMedical w1e9r5e3 The members of the symposium were unable to decide whaStcfiaecntcoerss responsible for the majority of cases but important conclusions I RICHARD DOLL were reached on more limited problems Firstly it was agreed that a significant part of the increase in mortality which had been reported from many countries is absolute and represents a real increase in the number of people suffering from primary cancer of the lung secondly that there is now evidence of an association between cigarette smoking and cancer of the lung and that this association is in general proportional to the total consumption and thirdly that occupational hazards giving rise to lung carcinoma have been demonstrated in a number of industries in particular in the handling of asbestos and chromates in works in a factory refining nickel and in certain mines active ores bearing ; Other possible etiological factors were considered particular atmospheric pollution by effluvia and smoke from factories and domestic chimneys and by exhaust fumes from petrol and diesel engines The possibility that carcinogenic agents might be absorbed through ingestion or skin contact was reviewed as was the possibility that individuals might vary in their susceptibility to the environmental influences to which they were exposed No positive conclusions were reached with regard to these latter problems ; In the last two years however much new evidence has been and it is now possible to give a more obtained the disease complete picture of the etiology of II INCREASE IN INCIDENCE 1. Extent of Increase The highest death rate from lung cancer is recorded in in 1953 it was 342 per million persons For both sexes takenBtroigteaitnhewrhleurneg cancer was the commonest type of fatal cancer accounting for 17 of all cancer deaths it accounted for % of male deaths from all causes at all disparity ages and in the age group 45 to 64 years for 10 of all male deaths In other countries for which detailed statistics are available the rate varies from a seventh to approximately thirds the British rate Table * The disparity between the rates is mainly due to between the rates for men with the exception of England and Wales Scotland and Finland the female rates are similar varying only between 34 and 47 per million women Each of the countries listed has experienced an increase in the mortality attributed to lung cancer in the last half century and the increase appears to be still continuing Fig ) In Table I the figures for EnglandEngland and Wales and for Scotland are shown separately The Scottish rate for all persons has usually been lower than the and Welsh rate but in 1953 the the English 342 per million rate was slightly higher per million against In England five years and now steady One steady and that age distribution genital epithelial that the maldee men i.e. to mor it stabilizes By Crude tp reyy, England and Scotland Finland Holland Switzerland U.S.A. Denmark Australia Canada France Sweden Norway Iceland Rates se born almafi of comnts Bowsted ikel im estimate that the . even greater l^n Much of the tres the population The and Wales for exas from S per million is if the sex and age with the sex and ag beginning of the cem per million The exte graphie changes is ti given by the compan the increases recorde