LUNG-CANCER IN NONSMOKING WOMEN - HISTOLOGY AND SURVIVAL PATTERNS

Background. Despite the widespread view that important clinical and et iologic differences exist between histologic categories of lung cancer , few studies have examined the accuracy of hospital-reported patholog ic diagnoses of lung cancer. Methods. A review of pathologic material and an assessment of survival patterns were conducted in conjunction w ith a recently completed case-control study of lung cancer among nonsm oking women in Missouri. Using established protocols, tissue slides fr om tumors of 482 patients were reviewed by 3 pathologists. Results. Ad enocarcinoma was the most common histologic type among former smokers and lifetime nonsmokers. The overall agreement rate between the origin al and review diagnoses was 65.6%. The positive predictive value range d from 0.33 for bronchioalveolar carcinomas to 0.84 for adenocarcinoma s. Agreement rates for small, medium, and large hospitals were 63.1, 6 6.6, and 66.2%, respectively. Survival rates were highest for bronchio alveolar carcinoma and lowest for small cell carcinoma. Conclusion. Gi ven the importance of lung cancer to public health and the need to exa mine risk by histologic type, these data indicate that pathologic revi ew of registry-reported lung cancer cases may be an important componen t of large scale studies of etiology.