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NOTE. 1 year figures are corrected; 3 years' figures are provisional.
It can be argued from these figures that the general prospects of survival have
become less meagre, especially if the case is an early primary lesion—the prospects of
survival of those undergoing pneumonectomy seem somewhat brighter; according to
Raven (1953) Taylor and Waterhouse found in 1950 that the five year survival rate in a
total of 1,134 cases was 13.7 per cent.; the survival rate for 133 cases operated on by
Sir Clement Price Thomas (of whom 33 were resectable but not strictly operable) was
25.5 per cent. (Brit. Med. J., 1954); Holmes Sellors (1955) states that cases operated on
prior to 1948 showed 21 per cent. alive after five years and in a 1949-50 series 34 per
cent. alive after three years; of 149 out of the 469 resectable American cases mentioned
earlier when the disease had not spread beyond the lung, the five year rate was 31 per
cent.
The lack of complete figures makes it difficult to assess in advance but it would
appear that it is still broadly true to say that mortality is a reflection of incidence a
little over a year previously (1.16 years in 1938-9 made up of 0.47 years to the commencement
of treatment and 0.69 years expectation of life during treatment)— currently,
the time interval between the onset of symptoms and the receiving of treatment seems
to have lessened but the expectation of life as the result of earlier and better treatment
has increased, although, so far as can be ascertained from Stocks' figures (admittedly
for nine years ago) not radically. It should be noted however that his figures do show
a very marked difference between the survival rates of early and late cases, which should
in due course be reflected in the overall rates, as the collective results of the earlier
seeking of advice and advances in diagnostic and surgical skill. From the public health
aspect one can only emphasise the fact that the crude survival rate of the early primary
male cases is three to four times that of the late ones for one year and eightfold for three
years.
References
Brit. Med. J. (1954), 2, 582. 'Detecting Lung Cancer.'
Brock, R. C. (1948). 'Diseases of the Chest.' Lancet, 2, 70.
Doll, R. (1953). 'Bronchial Carcinoma; Incidence and. Aetiology.' Brit. Med. J., 2, 521 and 585.
Edwards, F. R. (1954). 'Detecting Lung Cancer.' Brit. Med. J., 2, 752.
Harnett, W. L. (1952). 'A Survey of Cancer in London.' London.
Holmes Sellors, T. (1955). 'Results of Surgical Treatment of Carcinoma of the Lung.' Brit. Med. J., 1,445.
Lancet (1955), 1, 954. 'Cell Type in Bronchial Carcinoma.'
Logan, W. P. D. (1954). Brit. J. Prev. Soc. Med., 8, 128.
Ochsner, Ray and Acree (1954). American Review of Tuberculosis, 70.
Raven, R. W. (1953). 'Handbook on Cancer.' London.
Stocks, P. (1947). 'Studies in Medical and Population Subjects—No. 1.' H.M. Stat. Office, London.
Stocks, P. (1950). 'Studies in Medical and Population Subjects—No. 3.' H.M. Stat. Office, London.
Stocks, P. (1952). 'Studies in Medical and Population Subjects—Supplement to No. 3.' H.M. Stat. Office,
London.
'Symposium of the Endemiology of Cancer of the Lung.' Council for International Organisation of Medical
Science, Louvain. (1952).
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