Published: 2020-12-22

Histopathological subtypes of lung cancer presented at a tertiary care cancer hospital in Kerala: a cross sectional study

Sourabh Radhakrishnan, Sreeja Raju, Jamuna Angel Joy, Sanjana Ramakrishnan


Background: Lung cancer is one of the commonest cancers causes high rate of mortality worldwide. An increasing incidence of lung cancer and the pathological profile varies among gender and geographical regions. The present study was aimed to assess the pattern of histological subtypes of lung cancer and their distribution with age and gender.

Methods: Histologically proven primary lung cancers were selected from the cancer registry. Distribution of subtypes of lung cancer in various age and gender was collected. The major clinical presentation among the non-small cell lung carcinoma (NSCLC) and small cell lung carcinoma (SCLC) were also analysed. The data were statistically analysed.

Results: A total of 155 cases of lung cancers were analysed. Adenocarcinoma of lung was the most common subtype followed by squamous cell carcinoma and SCLC. Majority were males with age of presentation from 23 to 93 years. Age of presentation in the female group was 23-75 years. Significant difference was found between cancer numbers in male and female patients (p=0.0001). Statistically significant difference was found among the distribution of smokers and non-smokers in the NSCLC and SCLC patients (p=0.046). Most of the NSCLC and SCLC patients were presented with dyspnea and coughing.

Conclusions: Lung cancers were commonly seen in males and smokers. The most common histological subtype in males and females was adenocarcinoma. The diagnosis of histological subtype at the onset of clinical presentation of suspected cases of lung cancer is required to start the therapeutic regimen at the earliest to increase the longevity of patients.


Adenocarcinoma, Lung cancers, Squamous cell carcinoma, Small cell lung carcinoma

Full Text:



Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394-424.

Franklin WA. Diagnosis of lung cancer. Chest. 2000;117:80-9.

Silvestri GA, Pastis NJ, Tanner NT. Clinical Aspect of Lung Cancer. In: Broaddus VC. Murray and Nadelâs Textbook of Respiratory Medicine, 6th ed. Delhi: Elsevier. 2017;940-64.

Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol. 2006;24:2137-50.

Behera D. Epidemiology of lung cancer Global and Indian perspective. JIACM. 2012;13(2):131-7.

Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, et al. Cancer statistics, 2008. CA Cancer J Clin. 2008;58:71-96.

Ries LA, Eisner MP, Kosary CL, Hankey BF, Miller BA, Clegg L, et al., editors. Bethesda, MD: National Cancer Institute; 2004. SEER Cancer Statistics Review, 1975-2002. Based on November 2004 SEER Data Submission, Posted to the SEER Web Site; 2005. Available at: http://www.seer.cancer. gov/csr/1975_2002/. Accessed on 23 September 2020.

Kirmani N, Jamil K, Naidu MU. Occupational and environmental carcinogens in epidemiology of lung cancer in South Indian population. Biol Med. 2010;2:1-11.

Bilano V, Gilmour S, Moffiet T, d’Espaignet ET, Stevens GA, Commar A, et al. Global trends and projections for tobacco use, 1990-2025: An analysis of smoking indicators from the WHO comprehensive information systems for tobacco control. Lancet. 2015;385:966-76.

Standfield L, Weston AR, Barraclough H, Van Kooten M, Pavlakis N. Histology as a treatment effect modifier in advanced non-small cell lung cancer: A systematic review of the evidence. Respirol. 2011;16:1210-20.

Langer C J, Besse B, Gualberto A, Brambilla E, Soria JC. The evolving role of histology in the management of advanced non-small-cell lung cancer. J Clin Oncol. 2011;28(36):5311-20.

Charloux AE, Quoix N, Small WD, Pauli G, Kreisman H. The increasing incidence of lung adenocarcinoma: Reality or artefact? A review of the epidemiology of lung adenocarcinoma. International J Epidemiol. 1997;26(1):14-23.

Janssen-Heijnen MLG, Coebergh J WW. The changing epidemiology of lung cancer in Europe. Lung Cancer. 2003;41(3):245-58.

Behera D, Kashyap S. Pattern of malignancy in a north Indian hospital. J Indian Med Assoc. 1988;86:28-913.

Sheema S, Shah A, Arshed A, Makhdoomi R, Ahmad R. Histological Pattern of Primary Malignant Lung Tumours Diagnosed in a Tertiary Care Hospital: 10 Year Study. Asian Pacific J Cancer Prevention. 2010;11(5):1341-46.

Singh MP, Sharma MC, Mohanti BK, Shukla NK, Deo SVS, Mohan A, et al. Clinico-Pathological Profile of Lung Cancer at AIIMS: A Changing Paradigm in India. Asian Pacific J Cancer Prevention. 2013;14(1):489-94.

Houston KA, Henley SJ, Jun Li, White MC, Richards TB. Patterns in Lung Cancer Incidence Rates and Trends by Histologic Type in the United States, 2004–2009. Lung Cancer. 2014;86(1):22-28.

MLB Bhatt, Surya Kant, Ravi Bhaskar. Pulmonary tuberculosis as differential diagnosis of lung cancer. South Asian J Cancer. 2012;1(1):36-42.

Agrawal A, Kumar P, Tandon R. Pulmonary tuberculosis as a confounder for bronchogenic carcinoma due to delayed and misdiagnosis. Ind J Comm Health. 2013;25:438-44.

Standfield L, Weston AR, Barraclough H, Van Kooten M, Pavlakis N. Histology as a treatment effect modifier in advanced non-small cell lung cancer: A systematic review of the evidence. Respirol. 2011;16:1210-20.

Mok T. Personalized medicine in lung cancer: what we need to know.Nat Rev Clin Oncol 2011;8(11):661-810.

Pirker R, Herth FJ, Kerr KM, Filipits M, Taron M, Gandara D, et al. Consensus for EGFR mutation testing in non-small cell lung cancer: results from a European workshop. J Thorac Oncol 2010;5(10):1310-706.