Lung cancer and peripheral vascular surgery.

Lung cancer, a disease of epidemic proportions, is to some extent preventable. Elimination of smoking would certainly reduce its incidence. Conventional therapy has not produced any major advance in this field, the 5-year survival of all patients with lung cancer still being very low. The disease is best managed when detected at an early stage, but on the basis of a study carried out at the Mayo Clinic, screening of the general population cannot be advocated. A few high-risk groups of patients have been identified, such as those treated surgically for laryngeal or pharyngeal tumours and those previously operated on for lung carcinoma. The authors have identified another category of high-risk patients, those who must undergo peripheral vascular surgery. Of 676 patients operated upon for peripheral vascular disease, lung cancer was found in 3.25%. The distinction is made between those whose lung cancer was detected at the time of vascular surgery (synchronous) and those whose cancer was found later (metachronous). Every patient scheduled to undergo surgery for peripheral vascular disease should be screened by chest roentgenography and cytologic examination of the sputum. These patients should be followed up closely in the postoperative period.