LONG-TERM SURVIVAL OF PATIENTS WITH LUNG-CANCER FROM A DEFINED GEOGRAPHICAL AREA BEFORE AND AFTER RADIOLOGICAL SCREENING

In the County of Uppsala, Sweden, a general health survey including a chest roentgenogram was operational from the late 1960s until the end of June, 1985. The screening was offered every 2 years and participati on was about 70%. From the local cancer registry all cases of lung can cer during the period 1980-1990 aged 75 or less were obtained and thei r survival and mode of discovery investigated. Only WHO I-IV and undif ferentiated cancers verified histologically were included. Twenty-eigh t cancers (11.5%) were discovered in the survey and these patients had a very good prognosis compared to those who presented with symptoms. During the health survey there were 35 of 244 (14.3%) who survived mor e than 4 years, and after the survey this figure was 34 out of 265 (12 .8%), a nonsignificant difference. Survival for patients with squamous cell carcinoma or adenocarcinoma discovered in the health survey was much improved, and for these two groups combined the 4-year survival w as 41.7% compared to 10.3% for those discovered by symptoms (P < 0.001 ). Thus, survival of patients with lung cancer of squamous cell or ade nocarcinoma types can be improved by screening, but unfortunately, onl y few of the cancers will be discovered in this way, so the total impa ct of screening will be small.