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Communications to the Editor |

Lung Cancer Among Medical Professionals FREE TO VIEW

Hiroaki Satoh, MD; Yuko T. Yamashita, MD; Kiyohisa Sekizawa, MD
Author and Funding Information

University of Tsukuba Tsukuba City, Japan

Correspondence to: Hiroaki Satoh, MD, Division of Respiratory Medicine, Institute of Clinical Medicine, University of Tsukuba, Tsukuba-city, Ibaraki, 305-8575, Japan; e-mail: hirosato@md.tsukuba.ac.jp



Chest. 2002;122(4):1500-1501. doi:10.1378/chest.122.4.1500
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To the Editor:

Mortality rates and causes of death among the members of medical staffs, especially medical doctors, have been reported12; however, it is not clear whether lung cancer in such patients is at a more advanced stage at presentation than among members of other professions. In order to ascertain the characteristics of lung cancer in medical staffs, we reviewed the medical records of 1,021 lung cancer patients who had presented in our division between 1980 and 2001. There were 21 patients who were medical professionals (2.1%; 13 men; 7 doctors, 6 nurses, 3 dentists, 2 pharmacists, and 3 other technicians). The median age was 73 years (age range, 33 to 84 years). With regard to smoking, 71.4% of these 21 patients and 72.2% of 1,000 patients who had other professions were smokers. There were no differences between the two groups. In the 21 patients, pathologic examination revealed a preponderance of adenocarcinoma (14 patients). A lower frequency of squamous cell carcinoma and small cell carcinoma (SCLC) among the members of the medical profession was striking in contrast to that found in the 1,000 patients with other professions (p = 0.0152 [χ2 test]). Nineteen of the 21 patients who were medical professionals (90.5%) had stage IIIB or IV disease, which was a more advanced-stage disease than that found in the other 1,000 patients (p = 0.0111). Three patients underwent surgical resection, and 10 patients received chemotherapy. Five patients received radiation, and three patients received palliative care.

Our study indicated that lung cancer among medical professionals had a propensity for advanced tumor stage at presentation and that smoking might have influenced the development of lung cancer. Health-care professionals may have a tendency to delay seeking medical advice. It is not clear why a lower frequency of squamous cell carcinoma and SCLC was observed among medical professionals. It might depend partly on the higher ratio of female patients among them. The high prevalence of smoking among health-care professionals is striking. Since smoking is an important factor in the occurrence of lung cancer,35 effective programs aimed at abstinence and the cessation of smoking are required. Moreover, practical systems for detecting early-stage lung cancer among medical professionals are needed. The behavior of health professionals toward seeking medical attention is another issue that should be raised.

Doll, R, Peto, R (1977) Mortality among doctors in different occupations.BMJ1,1433-1436. [PubMed] [CrossRef]
 
Juel, K, Mosbech, J, Hansen, ES Mortality and causes of death among Danish medical doctors 1973–1992.Int J Epidemiol1999;28,456-460. [PubMed]
 
Stayner, LT, Wegman, DH Smoking, occupation and histopathology of lung cancer: a case-control study with the use of the Third National Cancer Survey.J Natl Cancer Inst1983;70,421-426. [PubMed]
 
Engeland, A, Haldorsen, T, Andersen, A, et al The impact of smoking habits on lung cancer risk: 28 years’ observation of 26,000 Norwegian men and women.Cancer Causes Control1996;7,366-376. [PubMed]
 
Thun, MJ, Lally, CA, Flannery, JT, et al Cigarette smoking and changes in the histopathology of lung cancer.J Natl Cancer Inst1997;89,1580-1586. [PubMed]
 

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References

Doll, R, Peto, R (1977) Mortality among doctors in different occupations.BMJ1,1433-1436. [PubMed] [CrossRef]
 
Juel, K, Mosbech, J, Hansen, ES Mortality and causes of death among Danish medical doctors 1973–1992.Int J Epidemiol1999;28,456-460. [PubMed]
 
Stayner, LT, Wegman, DH Smoking, occupation and histopathology of lung cancer: a case-control study with the use of the Third National Cancer Survey.J Natl Cancer Inst1983;70,421-426. [PubMed]
 
Engeland, A, Haldorsen, T, Andersen, A, et al The impact of smoking habits on lung cancer risk: 28 years’ observation of 26,000 Norwegian men and women.Cancer Causes Control1996;7,366-376. [PubMed]
 
Thun, MJ, Lally, CA, Flannery, JT, et al Cigarette smoking and changes in the histopathology of lung cancer.J Natl Cancer Inst1997;89,1580-1586. [PubMed]
 
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