Background: Sputum cytology was considered to be ineffective in previous National Cancer Institute trials for early lung carcinoma detection. However, sputum cytology was effective in identifying roentgenographically occult lung carcinoma in a community lung carcinoma identification program, where lung carcinoma was suspected on the basis of symptoms, smoking, or airflow obstruction.
Methods: The community project and the results of a newer lung carcinoma identification program were reviewed.
Results: Actuarial survival curves from a previously published study where 46 of 51 roentgenographically occult carcinomas could be treated by surgery (n = 27) or curative radiation therapy (n = 19) is presented. Overall survival, taking deaths from all causes at five years, was 54.4%. The serial study of high risk patients with airflow obstruction and more than 30 pack-years of smoking revealed a 1.8% yield of lung carcinoma. This is a higher yield than in mammography (0.3%-0.5%).
Conclusion: Sputum cytology can be useful in identifying lung carcinoma in its early and occult stages, particularly in patients at high risk for this disease.