Læknablaðið - 01.02.1973, Blaðsíða 28

16
LÆKNABLAÐIÐ
Ég held, að allir, sem til þekkja, séu
sammála um, að góður árangur náist ekki
við sytólogíska rannsókn nema með mik-
illi yfirlegu og alúð og langri þjálfun á
því sviði.
Hvað viðkemur aðstöðu til röntgen-
myndatöku við fjöldarannsóknir, þá hlýt-
ur hún að teljast ágæt hér.
Að öllu þessu athuguðu hljótum við að
stefna að því að hrinda í framkvæmd hér
hið fyrsta, skipulagðri leit að lungna-
krabba meðal reykingafólks í þeim aldurs-
flokkum, sem hættast er við að fá sjúk-
dóminn.
SUMMARY
One of the most striking features in mor-
tality statistics from nearly all of the develop-
ed countries is the steady and uninterrupted
rise in the incidence of bronchogenic car-
cinoma. There is £dso a close correlation be-
tween bronchial cancer and cigarette smoking
which is now generally accepted as the main
cause of the rising incidence of this disease.
During the period from 1931-1954 only 34
cases of bronchial cancer were reported in
Iceland in comparison with 261 cases during
the 14 year period from 1955-1968. The rising
incidence is closely associated with greatly
increased cigarette smoking (Thorarinsson et
al. 1967).21
Squamous cell carcinoma is generally the
most common histological type of lung cancer
(50-70% of all lung cancer in most countries).
In Iceland, however, the majority of the cases
of lung cancer are of the oat-cell and un-
differentiated type. The possible explanations
for this difference are discussed and the in-
teresting fact that the male/female ratio is
nearly equal (1.3:1) is also pointed out, which
is in contrast to the ratio found in other
European countries and North America where
this neoplasm is far more common in men
than women.
The only possible cure so far for this dis-
ease is surgical removal of the lesion, but the
five year suxvival is, however, still only 4-8%.
At the present time, the main emphasis
must therefore be on the early detection of
lung cancer. Mass chest X-ray and sputum
cytology screening surveys are expensive, but
we consider the periodical performance of
such surveys justifiable in the “high risk”
population groups, e. g. heavy smokers aged
40-70 years. However, it has been shown that
these screening techniques are deficient when
either one is used alone (Grzybowski et al.
1970) and they should therefore, if possible,
always be combined.
In Iceland the proportion of the rapidly
growing oat-cell and undifferentiated types of
bronchogenic cancer makes it even more ur-
gent to detect this disease at a very early
stage, in our opinion.
HEIMILDIR
1. Ashley, D. J. B. Environmental Factors in
the Aetiology of Lung Cancer and Bron-
chitis. British Journal of Preventive and
Social Medicine 23(4) :258-62. 1969.
2. Auerbach, O., Gere, J. B., Pawlawski,
J. M„ Muehsam, G. E„ Smolin, H. J. &
Stout, A. P. Carcinoma in situ and early
invasive carcinoma occurring in the
tracheobronchial trees in cases of bron-
chial carcinoma. J. Thor. Surg. 34:298.
1957.
3. Belcher, J. R. World-wide Differences in
the sex Ratio of Bronchogenic carcinoma.
Brit. J. Dis. Chest. 65:205. 1971.
4. Bergh, N. P„ Scherstén, T. Bronchogenic
Carcinoma Acta Chir. Scand. Supple-
mentum 347:7. Stockholm 1965.
5. Bjarnason, Ó. Cancer Incidence in Iceland.
Med. Monographs 2: Racial and Geographi-
cal Factors in Tumor Incidence. [Univer-
sity Press]. Edinburgh 1967.
6. Brett, G. Z. The Value of Lung Cancer
Detection by Six-monthly Chest Radio-
graphs. Tliorax 23:414. 1968.
7. Collins, V. P„ Loeffler, R. K. & Tivey, H.
Observation on Growth Rates of Human
Tumors. Am. J. Roentgenol. 76:988-1000.
1956.
8. Delarue, N. C. Cancer of the Lung. Can-
adian Family Physician 15(12) :40. 1969.
9. Gross, K„ Kubik, A. & Styblo, K. Studies
on Early Detection of Lung Cancer in a
District with a Population of Approximate-
ly 100.000 Inhabitants. Proceedings of the
First International Symposium on Detec-
tion of Cancer [Spa, Liege, Belgium], 319-
22. 1968.
10. Grzybowski, S. & Coy, P. Early Diagnosis
of Carcinoma of the Lung. Simultaneous
Screening with Chest X-ray and Sputum
Cytology. Cancer 25:113-20. 1970.
11. Hattori, S„ Matsuda, M„ Sugiyama, T. &
Matsuda, H. Cytologic Diagnosis of Lung
Cancer. Brushing Method Under X-ray
Television Fluoroscopy. Dis. Chest. 45:129.
1964.
12. Holman, C. W. & Okinaka, A. Occult Carci-
noma of the Lungs. J. Thor. Cardiov. Surg.
47:466. 1964.
13. Kubik, A„ Styblo, K„ Tomanek, A„ Gross,
K. & Svandova E, Lung Cancer Detection
and Tuberculosis Control in the District of
Kolin. Proceedings of the First Inter-
national Symposium on Detection of Can-
cer [Spa, Liege, Belgium], 327-31. 1968.
14. Mason, M. K. & Jordan, J. W. Carcinoma
in Situ and Early Invasive Carcinoma of
the Bronchus. Thorax 24:461. 1969.
15. Meyer, J. A„ Bechoid, E. & Jones, D. B.
Positive Sputum Cytologic Tests for Five
Years Before Specific Detection of Bron-