[Realities in the diagnosis of bronchial carcinoma in clinical and general practice]

In 100 patients with lung cancer the diagnostic procedure, results of clinical staging and therapeutic sequelae were analysed retrospectively and compared to a similar group of patients 10 years previously. During the 10 years' interval there was a remarkable shortening of the time between the onset of symptoms and the diagnosis, from 20 weeks to the present 10 weeks. Despite this acceleration the number of patients undergoing curative surgical resection increased only from 15 to 17%. Inoperability was still due to general condition in 14%, impaired lung function in 7%, advanced tumor stages with metastasis in 52% and local inoperability in 10%. Of the 77 patients with specific tumor related symptoms only 18 were in the prognostically favourable stage I, whereas in the asymptomatic group early stage I was observed in 13 out of 23 patients. We conclude that an improvement in early detection of lung cancer may be achieved by periodical screening of the high risk population, rather than by focusing on the onset of the first symptoms.