Radiation in Bronchogenic Carcinoma

To the Editor:—  Reference is made to your article entitled "One Factor in Increase of Bronchial Carcinoma" by Doctors Barnes and Ratzenhofer, which appeared in The Journal Dec. 31.The article states that there has been a definite increase in the association of bronchogenic carcinoma and tuberculosis which culminated in 1948, when 21 per cent of the autopsied patients with bronchogenic carcinoma had associated tuberculosis.The authors state that the advent of chemotherapy has increased the life span of tuberculous patients and preserves them long enough for the development of lung cancer. This is, of course, true; however, another factor must be considered— namely, the one of radiation exposure. In an unpublished study of tuberculosis hospital records of patients who were hospitalized in the years 1925-1940 it was found that it was nothing unusual for pneumothorax patients to have 200 fluoroscopies, some even had as many as 300, plus innumerable