Histologic typing of lung cancer in Louisiana

Our plain-English summary of Histologic typing of lung cancer in Louisiana, by H. Rothschild, H. Buechner, R. Welsh, et al (Cancer, 1982).

The study

• Authors: H. Rothschild, H. Buechner, R. Welsh, L.J. Vial, R. Weinberg
• Journal: Cancer
• Published: 1982;49(9):1874-7
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001771).

Abstract

To determine whether histologic patterns differed in the high- and low-lung cancer mortality parishes (counties) of Louisiana and whether the findings in the state differed from those in other parts of the United states, we studied the available histopathologic materials for 272 persons of the 815 who died of lung cancer in ten southern, nonurban Louisiana parishes during a seven-year period from 1971-1977. Squamous-cell carcinoma and small-cell anaplastic carcinoma were the most common tumor types, closely followed in frequency by adenocarcinoma, confirming reports by other investigators of a change during the past decade in the prevalence of various histopathologic types of lung cancer. The distribution of histopathologic types was not different for high- and low-mortality parishes but differed significantly from other areas of the U. S. Three persons had diagnoses consistent with pleural mesothelioma. Occupational histories obtained from relatives showed that one of those persons was a homemaker and the other two were sugarcane farmers with no discernable exposure to asbestos.

In plain English

This study looked at the microscopic type of lung cancer among people who died of lung cancer from 1971 to 1977 in ten southern Louisiana parishes. Of 815 such deaths, hospital records could be reviewed for 389. After exclusions, two pathologists reviewed tissue slides for 264 cases. Squamous-cell and small-cell anaplastic carcinoma were the most common types in white and black men. Among 44 women, 15 had small-cell and four had squamous-cell carcinoma, which the authors reported differed significantly from other studies. The mix of cancer types did not differ significantly between parishes with high and other lung cancer death rates. Three persons (1.1%) had diagnoses consistent with pleural mesothelioma. Next-of-kin reported no identifiable asbestos exposure for them; one was a homemaker and two were sugarcane farmers. The authors concluded that cell-type patterns and high lung cancer mortality in parts of southern Louisiana may be related. They noted that differences from other studies may reflect timing and case selection rather than geography, and that cured cancers were missed.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective review of tissue slides from people identified through death certificates as having died of lung cancer, with a panel reclassification of tumor types
• Who was studied: Of 815 persons who died of lung cancer in ten nonurban southern Louisiana parishes from 1971 to 1977, hospital records were available for 389 (48%).
• Exposure: No specific fiber or product exposure was studied. Tumor types were compared between parishes with high lung cancer mortality and other parishes. Occupational histories were obtained only for the three mesothelioma cases.
• Main results:
  • After excluding non-residents, cases diagnosed only clinically or radiologically, cytology-only cases, and cases with insufficient or metastatic material, 264 cases were studied.
  • Squamous-cell carcinoma and small-cell anaplastic carcinoma were the most common tumor types in white and black men.
  • Across all parishes, 73 cases were squamous-cell (28%) and 72 were small-cell anaplastic carcinoma (27%).
  • Among women, four of 44 had squamous-cell carcinoma and 15 of 44 had small-cell carcinoma.
  • The authors reported that this pattern in women differed statistically from the other studies they compared (p less than 0.05).
  • Women with squamous-cell carcinoma died at a younger mean age than men with the same type (61.3 versus 63.7).
  • The distribution of tumor types did not differ significantly between high-mortality parishes and other parishes (p greater than 0.05).
  • Three persons (1.1%) had diagnoses consistent with pleural mesothelioma.
  • For the three mesothelioma cases, next-of-kin occupational histories revealed no identifiable asbestos exposure. One was a homemaker and two were sugarcane farmers.
  • The review panel disagreed with the original hospital pathologists' classification in 34 (13%) of the cases.
• The authors' conclusion: The authors concluded that histologic patterns and the high lung cancer mortality in parts of southern Louisiana may be related, while stating that the reason for the geographic variation is unclear.
• Limitations the authors state:
  • Because cases came from death certificates, a small number of cured cancers, probably mostly squamous-cell, were not included.
  • Differences from other regions may reflect time rather than geography, because the data were gathered by different methods at different times.
  • Comparison with other investigators' data is difficult because of differential selection biases in how cases were chosen.
  • Comparison of panel diagnoses with hospital diagnoses may have been affected by differences in the classification system used.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Lung Cancer, Carcinoma, Adenocarcinoma, Pleural Mesothelioma.

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• Lung cancer risk among bricklayers in a pooled analysis of case-control studies — D. Consonni, S. De Matteis, et al. (2015)
• An attempt to use the WHO typing in the histological classification of lung carcinomas — A. Reinilä, K. Dammert (1974)
• p40 is the best marker for diagnosing pulmonary squamous cell carcinoma: comparison with p63, cytokeratin 5/6, desmocollin-3, and sox2 — T. Tatsumori, K. Tsuta, et al. (2014)
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