Epidemiological studies on lung cancer in the Bohemia region

In this epidemiological study, the incidence of lung cancer from 1981 to 1985 was evaluated in one district in the Central Bohemia Region with a population of 44,000. A total of 157 patients were identified as having lung cancer, the male:female ratio was 10:1, and 91% were smokers. Up to 78% of patients were detected because of their complaints, 17% at preventive examination, and 5% at autopsy. The calculated incidence for men was 129/100,000, for women 13/100,000. An average of 42 days elapsed from the time of the initial complaints or the preventive examination to the first visit with a pneumologist. From this visit to the establishment of the diagnosis an average of 28 days elapsed. In 79% of the patients, the diagnosis was confirmed histo- or/and cytologically, but mostly only by cytological examination; 15% of the whole group (23 patients) received surgery, four of whom underwent explorative thoracotomy alone; 18% had radiotherapy only; 12% received radiotherapy in combination with chemotherapy; 9% had chemotherapy alone; and 46% received symptomatic therapy only. In April 1992, the authors reviewed the series of patients and evaluated survival in different subgroups according to method of detection, morphological type, and TNM stage. Of the patients undergoing resection, 37% survived 5 years. In 13 patients, who died after successful resection, the cause of death was analysed. The majority succumbed to progression and dissemination of lung cancer. The authors conclude that prolonged survival could be demonstrated for resected patients, for patients at stages I and II, and for patients with squamous type of cancer.