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To determine the value of specific immunotherapy with adjuvant BCG in operable lung cancer, the immunological and clinical results of serial postoperative injections of autologous irradiated tumour cells and BCG were compared with those of a single preoperative injection of BCG in two randomly selected groups of patients undergoing resection of their tumours. There was a significant rise in tuberculin skin reactivity from seven weeks to 11 months after operation in the treated group. Actuarial curves for survival and freedom from tumour recurrence and median survival times showed an advantage for the treated patients who had stage I tumours, but these differences were significant only at the levels p = 0.07 - 0.09. Survival and duration of freedom from tumour recurrence was greater in autograft-treated patients whose skin responded to a weak test dose of dinitrochlorobenzene (DNCB) after sensitisation with 2% DNCB than in control DNCB-positive patients (p = 0.02). There were no significant differences in the actual proportion of patients from each group surviving at two years. The results show that this form of specific immunotherapy with adjuvant may have a beneficial effect in patients with stage I tumours and those who become sensitised to 2% DNCB after the first exposure. [ABSTRACT FROM AUTHOR]

In 52 patients undergoing tests of cell-mediated immunity before surgical resection of bronchial carcinoma a positive tuberculin test result was found in 71% compared with 68% of age- and sex-matched controls. Sensitisation to DNCB occurred in 52% of 37 patients but in 78% of controls. There was depression of lymphocyte transformation by PPD in 19 patients compared with controls (P=0.001), but there was no difference in lymphocyte transformation by PHA or pokeweed mitogen between 34 patients and controls. In a pilot study patients were randomly allocated to autograft (eight) or non-autograft (seven) groups. The autograft group were given an intradermal injection of a suspension of irradiated autologous tumour-cells mixed with intradermal BCG on the day of operation. Tests of cell-mediated immunity were repeated two weeks after operation. Five patients in each group received a course of radiotherapy to the mediastinum three weeks after operation. There was a rise in cutaneous tuberculin reactivity (P=0.08) and total leucocyte count (P=0.09) in the autograft group postoperatively with a fall in total lymphocyte and T lymphocyte counts in the non-autograft group (P less 0.05). These differences, however, were not followed by any difference in the frequency of tumour recurrence or the survival rate two years after operation. The results show that the immunological surveillance mechanism is impaired even in patients with early bronchial carcinoma and that it is possible to overcome postoperative immunological depression with specific immunotherapy combined with BCG. This treatment did not produce any clinical advantage in this small number of patients and the skin lesions caused the patients considerable discomfort. [ABSTRACT FROM PUBLISHER]

A general population cohort of 7055 men aged 45-64 and resident in Renfrew and Paisley, two urban burghs in the West of Scotland, has been followed for 10 1/2 years. Analysis of the cigarette smoking and lung cancer (incidence and mortality) relation has been undertaken in order to establish whether unusual results found in a case-control study of cigarette smoking and lung cancer in the adjacent city of Glasgow could be confirmed. Lung cancer incidence and mortality rates increased markedly for exposure categories up to an average consumption of 15-24 cigarettes per day. Above this level the rates increased only marginally. Expressing these rates relative to that estimated for the never-smoked group and comparing them with the relative risks estimated in the case-control study revealed a similarity in terms of both the shape and the level of the dose-response relation. Comparison of the lung cancer rates found in this cohort with those observed in other cohort studies in the literature (UK doctors, US Veterans, and American Cancer Society volunteers) suggested that the West of Scotland rates were substantially higher at all levels of cigarette exposure. [ABSTRACT FROM PUBLISHER]

Altogether 656 male lung cancer cases and 1312 age and sex matched controls were interviewed between 1976 and 1981 in a case-control study of cigarette smoking habits and lung cancer in Glasgow and the West of Scotland, an area with the highest recorded incidence in the world. The relative risk of lung cancer increased significantly for smokers whose consumption was below 20 cigarettes per day but did not rise significantly in those who smoked more than 20 cigarettes per day. Other smoking characteristics such as inhalation and tar yields of brands smoked did not explain this finding. Additionally, the relative risks observed at all levels of cigarette consumption were low in comparison with those in the published literature. By constructing an index of cigarette exposure which included the tar yields of brands smoked, an assessment of the risk of lung cancer in relation to tar exposure independent of amount smoked was derived. Only in smokers of less than 15 cigarettes per day was there a statistically significant reduction in risk of lung cancer associated with lower levels of tar yield. [ABSTRACT FROM PUBLISHER]

A survey of mean blood pressure levels in age-and-sex-matched samples of the population of the island of Tiree appears to support the local belief that blood pressure is higher on the island than on the mainland. This conclusion may be related to the observation of a greater mean width of the heart, measured radiologically, in the island population compared with the mainland population. The greater mean body weight observed in the island compared with the mainland may be a factor. Blood pressure in men between the ages of 40 and 59 years is higher in Tiree than in selected samples in England and America. [ABSTRACT FROM PUBLISHER]