ABSTRACT
Each year in the UK there are 46,000 cases of lung cancer, 24,800 cases in men and 21,600 cases in women; the mortality is declining in men, but increasing in women. Most patients present owing to intrathoracic symptoms: cough, haemoptysis, dyspnoea, chest pain, and recurrent chest infections. Physical signs may be detected by an rxamination of the hands which may reveal clubbing, characterized by an increase in nail convexity in the transverse and longitudinal planes, loss of the nail fold angle and sponginess of the nail bed on compression of the nail. Investigations include chest X-ray, sputum cytology/core biopsy, bronchoscopy, and computed tomography. Ninety percent of patients with pleural mesothelioma present with increasing dyspnoea on exertion and/or chest discomfort on the affected side. Finger clubbing and signs of chronic respiratory compromise can occur if there has been prior asbestosis.
