[Effectiveness of photofluorography screening studies in the early detection of bronchial carcinoma]

Abstract

Report on results of a prospective study for earlier detection of peripheral and central bronchial carcinoma by fluorography performed for 6 years. In 1972 41,532 men of the age groups 1907 to 1937 were enrolled in the study group examined every 6 months. They were compared statistically and clinically to a control group of 102,348 persons of about the same sex and age distribution examined every two years by mass-x-ray. 1. By fluorographic screening the detection and resection rate in the study group was significantly increased. The percentage of resections was double as high as in the control group. 2. The higher detection rate especially in the younger age groups (40 to 54 years) of the study group caused an increase of the resection rate being three times higher than in the corresponding age group of the control population. 3. 67.5% of the persons with resection in the study group and 49.5% in the control group came to a life expectancy of more than three years. A 5 years healing after resection was attained by 23 of 42 resected patients of the study group and by 15 among 46 of the control group (55% to 32%). 4. Fluorography in 6 months intervals led to an increase of lower tumor stages. 5. At present fluorographic examinations showed to be the only mode of detection with good chances of resection as well in the study as in the control group, case-finding with clinical methods offering only small chances. 6. Among the patients resected in the study group the histological type of adenocarcinoma was rather frequent in 26.0%, parvicellular carcinoma amounting to 13.5%, on the other hand in the control group these types could be found with the same frequency in 16.8%. 7. The own results are reviewed with national and international investigations. Fluorographic examinations of selected risk groups (males between 40 and 70 years) in short intervals have proved to be at present the only method of finding bronchial carcinoma in time with some effectivity. 8. The effectivity of mass-x-ray-examinations must be improved a) by aimed examinations of risk groups, b) by improving the operational approach of fluorography using a special data bank of inhabitants, c) by reducing the medical protraction still high up to diagnosing bronchial cancer, d) by using the computer controlled risk aimed x-ray-examination for a complex screening programme.