Causes of Death in Carcinoma of the Lung in a Large Public Hospital

An Analysis of 186 Fatalities

¹ Professor of Clinical Surgery, Tulane University of Louisiana School of Medicine; Senior Visiting Surgeon, Charity Hospital of Louisiana at New Orleans.

A distressing picture emerges from the analysis of 186 fatalities from carcinoma of the lung at Charity Hospital of Louisiana at New Orleans. Patients often delayed seeking treatment. Private physicians and hospital staff often failed to suspect the diagnosis or were slow to recommend surgery. The investigation was sometimes perfunctory, sometimes unnecessarily repetitious, and sometimes enmeshed in hospital routine and protocol. Appallingly often the clinical course was far too brief to permit any positive action. If the mortality is to be lowered in this disease, which is now of major importance among malignant diseases, the profession must (1) develop a far higher index of suspicion concerning it; (2) explore the chest on suspicion much oftener; (3) stress the urgency of diagnosis and treatment; (4) investigate the whole man rather than limited fields whenever adults seek medical care for any reason whatsoever; and (5) make the fullest possible use of data available in mass chest surveys.