The early identification of lung carcinoma by sputum cytology.

Abstract

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. The community project and the results of a newer lung carcinoma identification program were reviewed. 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%). Sputum cytology can be useful in identifying lung carcinoma in its early and occult stages, particularly in patients at high risk for this disease.