Tobacco Smoking as a Possible Etiologic Factor in Bronchiogenic Carcinoma: A Study of Six Hundred and Eighty-Four Proved Cases

JAMA: The Journal of the American Medical Association

Volumn 253, Issue 20, 1985, Pages 2986-2994

  Wynder, Ernest L ^a   Graham, Evarts A ^a  

^a WASHINGTON UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; HISTORY; HISTORY OF MEDICINE; HUMAN; LUNG CARCINOMA; LUNG TUMOR; SMOKING; UNITED STATES;

CARCINOMA, BRONCHOGENIC; HISTORY OF MEDICINE, 20TH CENT.; HUMAN; LUNG NEOPLASMS; SMOKING; UNITED STATES;

EID: 0022431522     PISSN: 00987484     EISSN: 15383598     Source Type: Journal    
DOI: 10.1001/jama.1985.03350440064033     Document Type: Article

References (32)

1. Ochsner, A., and DeBakey, M.: Surgical Considerations of Primary Carcinoma of the Lung, Surgery 8:992-1023 (Dec.) 1940.
2. Wheeler, R.: Personal communication to the authors.
3. Avery, E. E.: Personnal communication to the authors.
4. Kenneway, N. M., and Kenneway, E. L.: A Study of the Incidence of Cancer of the Lung and Larynx, J. Hyg. 36:236-267 (June) 1936.
5. Kenneway, E. L., and Kenneway, N. M.: A Further Study of the Incidence of Cancer of the Lung and Larynx, Brit. J. Cancer 1:260-298 (Sept.) 1947.
6. Statistics on Cancer, New York, American Cancer Society, Statistical Research Division, 1949, p. 19.
7. Adler, I.: Primary Malignant Growths of the Lungs, and Bronchi, New York, Longmans, Green and Co., 1912.
8. Tylecote, F. E.: Cancer of the Lung, Lancet 2:256-257 (July 30) 1927.
9. Hoffman, F. L.: Cancer of the Lung, Am. Rev. Tuberc. 19:392-406 (April) 1929.
10. McNally, W. D.: The Tar in Cagarette Smoke and Its Possible Effects, Am. J. Cancer 16:1502-1514 (Nov.) 1932.
11. Lickint, F.: Der Bronchialkrebs der Raucher, München med. Wchnschr. 82:1232-1234 (Aug. 2) 1935.
12. Arkin, A., and Wagner, D. H.: Primary Carcinoma of the Lung, J. A. M. A. 106:587-591 (Feb. 22) 1936.
13. Roffo, A. H.: Der Tabak als Krebserzeugende Agens, Deutsche med. Wchnschr. 63:1267-1271 (Aug. 13) 1937.
14. Maier, H. C.: Personal communication to the authors.
15. Müller, F. H.: Tabakmissbrauch und Lungencarzinom, Ztschr. f. Krebsforsch. 49:57-85, 1939.
16. Ochsner, A., and DeBakey, M.: Carcinoma of the Lung, Arch. Surg. 42:209-258 (Feb.) 1941.
17. Schrek, R.; Baker, C. H.; Ballard, G. P., and Dolgoff, S.: Tobacco Smoking as an Etiological Factor in Disease: I. Cancer, Cancer Research 10:49-58 (Jan.) 1950.
18. Wynder, E. L., and Graham, E. A.: Tobacco and Bronchiogenic Carcinoma: Preliminary report to the National Cancer Conference, Memphis, February 1949.
19. The questionnaires were sent to male and female patients with cancer of the lungs from Dr. W. L. Watson's Thoracic Surgery Service at Memorial Hospital, New York.
20. California: Private patients of Drs. L. Brewer, Daniels, F. Dolley, D. Dugan, H. Garland, E. Holman, J. Jones, W. Rogers, P. Samson, B. Stephens. Hospitals: Birmingham General, French, Good Samaritan, Letterman General, Los Angeles County, Southern Pacific General, Stanford, United States Marine, United States Naval, University of California, Wadsworth General. Colorado: Private patients of Drs. A. Brown, F. Condon, J. Grow, F. Harper, M. Peck. Hospitals: Colorado General, Denver General, Fitzsimmons, Fort Logan Veterans, General Rose, St. Lukes. District of Columbia: Private patients of Drs. B. Blades, E. Davis. Hospitals: Georgetown, George Washington, Walter Reed. Illinois: Hospitals: Cook County, Veterans Administration, Hines, Ill. Maryland: Hospitals: Johns Hopkins, United States Naval. Massachusetts: Private patients of Drs. D. Harken, R. Overholt. Hospitals: Boston City, Massachusetts General, New England Deaconess. Michigan: Hospitals: Dearborn Veterans. Missouri: Private patients of Drs. J. Flance, A. Goldman, R. Smith. Hospitals: Jefferson Barracks Veterans, Jewish, St. Louis City, St. Louis County. New Jersey: Hospitals: Berthold S. Pollack, Newark City. New York: Private patients of Drs. W. Cahan, H. Maier, J. Pool, W. Watson. Hospitals: Bellevue, Veterans Administration, Brooklyn Cancer Institute, Kings County Memorial, Montefiore, New York City Cancer Institute, New York Hospital, Presbyterian, Roswell Park Memorial Institute. Ohio: Hospitals: Veterans Administration. Pennsylvania: Private patients of Dr. J. Johnson. Hospitals: Jefferson Medical College, Temple University, University of Pennsylvania. Utah: Private patients of Drs. W. Rumel, Cutler, Hospitals: Holy Cross, St. Marks, Salt Lake County General, Veterans Administration, Dr. W. H. Groves, Latter-Day Saints.
21. Betty G. Proctor, A.B., and Adele B. Croninger, M.A.
22. City Hospital, Jewish Hospital and Veterans Administration Hospital.
23. 13.6×2.3/100 = 0.312. This is the quotient which, added to the others determined in the same manner, makes the data shown in figure 3.
24. Of the service of Dr. James B. Amberson.
25. Of the service of Dr. John W. Strieder.
26. Eight of these cases were diagnosed in Dr. Papanicolaou's laboratory on conclusive evidence of carcinoma. One sputum and one pleural fluid examination were made in the Boston City Hospital.
27. Includes 3 cases of Dr. C. T. Surington and 1 case of Dr. H. G. Turner.
28. Includes 4 cases of Dr. H. G. Turner and 3 cases of Dr. G. W. Ware.
29. See table 5.
30. It is taken for granted, of course, that by itself such parallelism would mean little since similar curves could be drawn for many other commodities.
31. Lindskog, G. F.: Bronchiogenic Carcinoma, Ann. Surg. 124:667-674 (Oct.) 1946.
32. Lindskog, G. F., and Bloomer, W. D.: Bronchiogenic Carcinoma, Cancer 1:234-237 (July) 1948.