J.Jpn. Surg. Soc.. 56(6): 659-665, 1955
宿題報告
THE PRESENT CONDITION OF PULMONARY TUMORS IN JAPAN
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Surgical Department, Tiba Uinversity Medical School Naoji KAWAI |
The incidence of lung cancer is definitely increasing each year. It comprised 2.4% of all autopsies during the last decade, about 3 times that of 20 years ago (Nagayo's statistics).
Sex distribution is about 4 : 1 for male and female. Age distribution shows its peak in the fifth decade of life, followed by the fourth and sixth decades, which together comprise about 80% of the total lung cancer.
Present situation regarding diagnosis: Unfortunately it should be admitted that diagnosis is very much behind, based on the following facts:
1. Annual death rate of lung cancer in Japan is very low compared to those of Europe and America.
2. Upon reviewing the symptoms on admission, we found that many of the cases were diagnosed only after the appearance of signs of mediastinal compression or palpable lymphatic metastasis.
3. The period from the onset of the disease to the time of definitive diagnosis averages about 6 months while the period from the definitive diagnosis to death averages about 3 months. It is thus shown that longer than two thirds of the period from the onset to death elapses before diagnosis.
4. Bases of diagnosis―About 60% of the total are presumptive diagnosis, majority of which being based solely on X-ray findings and very few cases availing of special diagnostic procedures.
In short, diagnosis is delayed so that surgeons have to cope with more of advanced cases.
Present situation regarding treatment:
Since diagnosis is delayed, it follows also that treatment is delayed. Only less than 30% of the cases were operated while the remaining 70% received only chemotherapy, X-ray therapy or symptomatic treatment.
The post-operative periods of all the cases that had undergone excisional therapy are short, showing that the history of pulmonary excision in Japan is brief.
(author's abstract)
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