Medicine: X Rays and Lung Cancer

Has medical science an answer to the increase of lung cancer? Some doctors have urged wholesale chest X rays of the population at large, and especially of men over 45. But last week the American Roentgen Ray Society heard a vigorous dissent.

Stanford University’s Dr. Leo H. Garland reported that unselected screening has turned up only an average of ten cases of lung cancer for every 100,000 persons examined, and he calculated that X rays taken every six months of men over 45 would show 50 cases per 100,000. There are 22 million men in that age group in the U.S., and each year they would need at least 44 million minifilms (35-mm.), plus 1,000,000 larger films for checking suspected cases.

Moreover, argued Radiologist Garland, many victims of lung cancer do not submit to surgery promptly after diagnosis, so they get no benefit from the procedure. Worst of all, surgery adds but little to the life expectancy in most cases. Concluded Dr. Garland: “The yield in lives actually saved or even made more comfortable by this [Xray] program . . . appears to be so small that one cannot urge its imposition on the general public . . .”

Many of his colleagues thought that Dr. Garland was unduly pessimistic. Some mass X-ray surveys, they argued, have turned up much higher percentages of lung-cancer cases than those he cited. By improving their techniques, some doctors hope to do an even better job of detection. Washington’s Dr. Edgar W. Davis suggested one improvement—X-ray specialists should realize that half of the tumorlike masses which appear benign on the plate are actually malignant, so that the rule should be: when in doubt, operate as early as possible.