[Current roentgenologic delay in bronchial carcinoma].

Abstract

The actual delaying of findings in roentgenograms is represented in 1000 cases of resected bronchial carcinoma from 1957 to 1972 and in 800 unresectable patients from 1973 to 1976. The delaying is analysed using the criteria as localization, site, diameter, histology, clinical delaying of symptoms, manner of discovering the tumour, original finding in the roentgenogram, prognosis, and sex-distribution of the tumours. 1. In 40% of the 1000 resected patients a delay of findings in roentgenograms may be pointed out. 2. Lung cancer is the best discovered by x-ray examination. 69% of 1000 resectable patients, suffering from lung cancer, were discovered by the people's x-ray screening (VRRU). Nevertheless 45-50% of these VRRU-cases are showing a delaying of findings in roentgenograms by more than 6 months. Even in patients, discovered by clinical symptoms, a delaying of findings after x-ray examinations was found, 26% of these patients showing abnormal x-ray findings at the time of diagnosis existing but unheeded already for 6 or more than 24 months. 3. In 10-15% of the cases resection could not be done to delaying of findings in roentgenograms. 4. In most cases the focus of peripheral tumours in roentgenograms is delayed (in 50% for 6 to more than 24 months). 5. In 74% of cases in women a roentgenographic delay was found by 6 to more than 24 months. As a matter of fact, only 10% of all patients were women. 6. Among the central tumours with plain densities the squamous cell carcinomata had findings markedly longer before diagnosis than small cell carcinomata. Among the peripheral tumours alveolar cell carcinoma and adenocell carcinoma are the longest delayed, followed by small (oat) cell carcinoma, polymorph cell carcinoma and squamous cell carcinoma. 7. Positive unheeded x-ray screening series under 6 months remained unregarded in our analysis. But even these series might be still improved. As a conclusion is stated: the detection and prognosis of lung cancer might be improved a) by increasing the quality of reading and interpretation of the VRRU, b) by differentiating the x-ray-intervals according to the risk of lung cancer in each person, c) by a constant algorithm in the diagnosis of suspect findings in roentgenograms.