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The early identification of lung carcinoma by sputum cytology
1University of Colorado Health Sciences Center, Denver 80218, USA. tlpdoc@aol.com
Background:
Sputum cytology was considered to be ineffective in previous National Cancer Institute trials for early lung carcinoma detection. However, sputum cytology was effective in identifying roentgenographically occult lung carcinoma in a community lung carcinoma identification program, where lung carcinoma was suspected on the basis of symptoms, smoking, or airflow obstruction.
Methods:
The community project and the results of a newer lung carcinoma identification program were reviewed.
Results:
Actuarial survival curves from a previously published study where 46 of 51 roentgenographically occult carcinomas could be treated by surgery (n = 27) or curative radiation therapy (n = 19) is presented. Overall survival, taking deaths from all causes at five years, was 54.4%. The serial study of high risk patients with airflow obstruction and more than 30 pack-years of smoking revealed a 1.8% yield of lung carcinoma. This is a higher yield than in mammography (0.3%-0.5%).
Conclusion:
Sputum cytology can be useful in identifying lung carcinoma in its early and occult stages, particularly in patients at high risk for this disease.