Smoking & Cancer (Contd.)

People who doubt that heavy cigarette smoking is a major cause of lung cancer have argued that there could be no real proof until comparison was made between groups of smokers and nonsmokers who are identical in all other major respects. Some have insisted that the villain in the lung-cancer picture is industrial air pollution. This week, under Los Angeles' smoggy pall, researchers reported on a study designed to refute both arguments.

Dr. Ernest L. Wynder of Manhattan's Sloan-Kettering Institute and Dr. Frank R. Lemon of the College of Medical Evangelists in Loma Linda made a joint report to the California Medical Society. Basis of their study: 8,692 patients admitted to eight Seventh-day Adventist hospitals in southern California in 1952-56. Of these, 564 were Seventh-day Adventists who did not smoke or drink because their religion forbids, while 8,128 were of persuasions that take no stand on tobacco or alcohol, so many, but not all, both smoked and drank. All patients had either cancer or coronary artery disease, or had suffered heart attacks.

Since the Adventists made up 8.8% of the total, and were comparable in age, sex, occupations, residence and other key characteristics, they might have been expected to be afflicted by disease in the same proportion. Not so, Drs. Wynder and Lemon found. Items: P:Against an expected ten cases of lung cancer among Adventists, there was only one, a man who died of lung cancer in 1955. He had smoked a pack a day for 25 to 30 years before joining the church in 1941, then had sworn off. (As a former metal worker, he may have been exposed to cancer-causing substances.) P: Heart attacks were only 60% as common among Adventist men as among other men (though equally common in women of both groups), and occurred at later ages: only 2% before age 44, as against 8% among non-Adventists; 12% before 54, as against 30%; and 38% before 64, as against 62%. P:Cancer of the mouth, larynx or gullet, which has been associated by Dr. Wynder with a combination of heavy smoking and hard drinking (TIME, June 13, 1955) was only 10% as frequent among Adventist males; the single case recorded was cancer of the lip.

Other common cancers, which have not been associated with smoking or drinking habits, e.g., those of the breast, prostate, stomach, colon, rectum and uterus, as well as leukemia, occurred at just about the same rates in both Adventist and non-Adventist patients. This uniformity led Drs. Wynder and Lemon to conclude that heavy cigarette smoking and hard drinking are indeed major factors in lung or mouth cancer and in hastening death from atherosclerosis (hardening) of the coronary arteries. "We propose," they said, "that smoking, though not causing atherosclerosis as such, adds to the already damaging effect of atherosclerosis upon the circulatory system." As for air pollution, they noted that more than half the subjects in both groups studied lived in smoggy parts of Los Angeles. Hence, they argued, air pollution by itself is probably not a major factor in lung cancer, though they conceded that it may be a co-factor with smoking.

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