Epidemiologic trends in lung cancer over two decades in Northern Greece: an analysis of bronchoscopic data.

BACKGROUND AND AIM: The relative frequency of histological subtypes of lung cancer in Europe has changed dramatically during the 20th century. The aim of this study was to explore the changing epidemiology of lung cancer in Northern Greece over the last two decades. METHODS: From the extensive database of the Bronchoscopy Unit of the G. Papanicolaou General Hospital, Thessaloniki, Greece, we identified all patients with a histologic and/or cytologic report positive for lung cancer over two consecutive decades. RESULTS: Between 1/1/1986 and 31/12/2005 we identified 9981 patients with specimens positive for lung cancer. A significant increase in mean patient age was observed during the second decade (64.8 +/- 9.4 vs. 62.1 +/- 8.9, p=0.001). Men developed lung cancer ten times more often than women. The predominant histological type was squamous cell cancer in males (4203 cases, 45.7%) and adenocarcinoma (418 cases, 52.6%) in females. The number of lung cancer cases was significantly higher during the second decade compared to the first decade (5766 cases [57.8%] vs. 4215 cases [42.2%], respectively, p<0.001). There was a significant decrease in the percentage of squamous cell carcinoma in males in the second decade (2317 cases [44.1%] vs. 1886 cases [48.0%], p<0.001), and an increase in adenocarcinoma (1021 cases [19.4%] vs. 609 [11.6%], p<0.001). In females, the relative incidence of adenocarcinoma was decreased and that of squamous cell carcinoma was increased, but not significantly. There was no obvious change in the incidence of small cell lung cancer. Neoplastic lesions were most often located in the upper lobes. CONCLUSION: The number of lung cancer cases has increased in the last decade. Squamous lung cancer appears to be decreasing in men and increasing in women. Adenocarcinoma appears to be increasing in men and decreasing in women. There appears to be no change in small cell lung cancer. During the second decade there has been a significant decrease in the male: female ratio.

Incidence and prognostic value of positive peritoneal cytology in colorectal cancer.

PURPOSE: This study was conducted to investigate the incidence of free cancer cells in the peritoneal washings of patients who had undergone surgery for colorectal cancer and to evaluate its influence as a prognostic factor of the disease. METHODS: From 1990 to 1996, intraoperative washing cytology was performed in 110 patients who underwent surgery for colorectal cancer. All patients had curative resections. Immediately after the abdomen was opened and before exploration and mobilization of the tumor, 100 ml of saline was injected over the tumor site. Washings were then aspirated and taken for cytologic examination. RESULTS: Twenty-two (20 percent) of 110 patients examined were found to have positive cytology for intraperitoneal free malignant cells. The site of tumor in the colon or rectum, tumor size, nodal status, degree of differentiation, mucinous characteristics, and vascular or neural invasion were found not to affect the incidence of free cancer cells. Conversely, tumor penetration was found to affect the incidence of positive cytology. The degree of association among the stages of tumor penetration was indicated by the contingency coefficient, which was 0.42. Patients with positive cytology had a significantly higher rate of local recurrence and peritoneal carcinomatosis (22.8 vs. 8 percent, P = 0.05) than patients with negative cytology. Mortality rate was not found to be related to the presence of free cancer cells. CONCLUSION: Cytologic examination of peritoneal lavage at the time of surgery could be a useful prognostic indicator for local and peritoneal recurrence rate. However, it was not found to be a predictor of survival.