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November 13, 1967

Pneumonia as an Early Sign Of Bronchogenic Cancer

JAMA. 1967;202(7):665. doi:10.1001/jama.1967.03130200151042

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To the Editor:—  It seems appropriate at the start of this winter season to remind physicians that the symptoms and signs of bronchogenic cancer are indistinguishable from those of pneumonia. There is a recurring pattern, in case histories of cancer, of excessively long treatment for slowly resolving pneumonitis before the realization of the true nature of the patient's illness comes about. It should be kept in mind that the most important respiratory disease of American males today is bronchogenic cancer, not pneumonia.Practitioners should consider malignancy at the very outset of pneumonitis in males over 30, especially those who are heavy smokers, and initiate diagnostic tests early. The simplest and possibly the most accurate procedure is to obtain a series of sputum samples for cytological analysis at the start of illness in every instance of pneumonitis. (Bacteriological examination would also be worthwhile.) Granted that surgical cure is uncommon, it is