Information was recorded prospectively on 2586 unselected patients with lung cancer seen in hospital during 1981-4. Twenty eight per cent were female and 97% were current smokers or ex-smokers. Two thirds were aged under 70 at the time of diagnosis. The cell type was known in 2117 patients (82%). In the 579 women there was a larger proportion with small cell carcinoma (29% v 21%) and adenocarcinoma (18% v 11%) but a smaller proportion with squamous cell carcinoma (38% v 52%; p less than 0.01) than among the men. The women were also significantly younger. Small cell carcinoma was also more common and squamous cell carcinoma less common in patients aged less than 60 years (p less than 0.01). Only 47 (7%) of the 651 patients diagnosed in 1981 were alive at five years; 35 of the 116 highly selected patients who underwent surgical treatment survived (30%), compared with 17% (7/42) of patients given radical radiotherapy and 1% (5/493) in the patients given palliative radiotherapy, chemotherapy, or symptomatic treatment only. The current outlook for patients with lung cancer remains very poor and the major emphasis must clearly be on prevention.
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