History and Epidemiology

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LC was a curiosity in the nineteenth century. Only 350 cases were reported in the medical literature as late as Adler's review in 1912. There was a sudden increase in incidence in the 1920s. Almost all cases were in men, and a striking association with cigarette smoking was soon noted. Ernst Wynder, a medical student working with Evarts Graham, collected retrospective data documenting a strong correlation of the disease with cigarette smoking. This finding was confirmed in large retrospective studies performed by Hammond and Horn. Auerbach demonstrated sequential pathologic changes in the bronchial mucosa in smokers, but not nonsmokers, in two large postmortem studies. Smoking was associated with bronchial hyperplasia, dysplasia, carcinoma in situ and invasive bronchogenic carcinoma. Similar changes

Surgical Oncology, edited by David N. Krag. ©2000 Landes Bioscience.

Fig. 12.1. Tobacco industry executives swear that nicotine is not addictive, before a Congressional committee. © 2000 American Lung Association. Reproduced with permission.

were noted in experimental animals in a famous study of beagle dogs exposed to tobacco smoke.

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