Lung cancer historical perspective


 * Assistant Editor(s)-In-Chief: Michael Maddaleni, B.S.

Overview
Today, lung cancer is one of the leading causes of death worldwide, killing over 1 million people per year but it was not always that way. Approximately 150 years ago, lung cancer was actually a very rare disease. At the Institute of Pathology of the University of Dresden in Germany, lung cancer represented only 1% of all cancers seen at autopsy.

Lung cancer steadily rose from this point on and in 1918 the percentage had risen to nearly 10% and by 1927, it represented more than 14% of all cancers. Around this time period, the disease had a life expectancy from about 6 months to 2 years and in most cases, the afflicted individual had had long term chronic bronchitis.

Smoking
When lung cancer started to become prevalent, tobacco use was not one of the suspected culprits. In the 1930 edition of the Springer Handbook of Special Pathology smoking was briefly mentioned in 1 or 2 sentences as a possible cause. It did point out that many investigations had shown no correlation between smoking and lung cancer. Although the majority of countries didn't suspect the chemicals in smoke as carcinogens, a German physician, Fritz Lickint published a paper in which he said that lung cancer patients are likely to be smokers. Lickint went on an anti-smoking crusade and it actually caught on relatively strongly in Germany.

By 1969, a new edition of the handbook had 25 detailed pages of the role of cigarette smoking and lung cancer. Contrary to popular belief, between 1930 and 1969 (when the new edition of the handbook was released) there actually were actually studies done determining the detriments of smoking. A case control study in Germany in 1940 was published in which the author stated that “the extraordinary rise in tobacco use was the single most important cause of the rising incidence of lung cancer” (Müller). Also, in 1943, the German Institute for Tobacco Hazards Research released a study which showed that out of 109 lung cancer patients, only 3 of them were non-smokers. Although studies like these existed, it took quite some time for the connection between lung cancer and smoking to catch on.

Radon
As early as 1500, attention was called to a certain condition that was not known at the time to be anything cancerous. In two German regions, there were successful mines of silver, nickel, cobalt, bismuth, and arsenic. 60 to 80% of all the miners in these mines died from a disease they called Bergkrankheit (mountain sickness). Lung cancer in miners became considered an occupational hazard. It was thought that the chemical constituents, such as arsenic, were the cause of this deadly disease but it was also suspected that so called radium emanation was the main cause. In 1924, measurements published by a German physics journal confirmed that there were very high concentrations of radon gas in the mines. Some of them had concentrations as high as 18,000 picocuries per liter.