Epidemiology of lung cancer in Eastern India with focus on histopathological subtypes and smoking history: a single rural tertiary center experience
Keywords:Adenocarcinoma, Loss of weight, Non-small-cell carcinoma, Metastatic
Background: Lung cancer is the most common cancer and the leading cause of mortality worldwide. Smoking remains the commonest risk factor for development of lung cancer. This study aimed to evaluate the histopathological subtypes and smoking history among patients with lung cancer.
Methods: This was a retrospective observational study that included all the patients attending Radiotherapy OPD of Burdwan Medical College during 2017 and 2018. Demographic data, smoking history, comorbidities, symptoms, smoking history, histology of lung cancer, stage at presentation, site of metastasis, and site of lesions were collected.
Results: There were 484 patients, with a median age of 59 years, of which 82.4% were men and 17.6% were women. The men-to-women ratio was 4.7:1. Regular smoking was common in patients with lung cancer (72.7%). Total 12.4% of patients had small-cell carcinoma; of the 87.6% patients with non-small-cell carcinoma, the most common histology was adenocarcinoma (44.6%), followed by squamous cell (38.4%), large cell (17.0%). The most common metastatic sites were lung (42.1%) followed by bone (34.1%), lymph node (15.9%), liver (2.7%), vertebra (2.5%), pleura (2.1%), and anterior chest wall (0.6%). A larger proportion of men (92.6%) were smokers as compared women. There was a statistically higher occurrence of adenocarcinoma in smokers than in non-smokers (62.2% vs. 2.4%; p<0.001). The majority of patients with a smoking history (73.0%) were found to have advanced cancer (Stage IV).
Conclusions: The present study confirmed that apart from smoking history, demographic characteristics appear to have an impact on lung cancer development.
Mathur P, Sathishkumar K, Chaturvedi M, Das P, Sudarshan KL, Santhappan S, et al. Cancer Statistics, 2020: Report From National Cancer Registry Programme, India. JCO Glob Oncol. 2020;6:1063-75.
Noronha V, Pinninti R, Patil VM, Joshi A, Prabhash K. Lung cancer in the Indian subcontinent. South Asian J Cancer. 2016;5(3):95-103.
Behera D. SC17.03 Lung Cancer in India: Challenges and Perspectives. Journal of Thoracic Oncology. 2017;12.1S:S114-5.
Kaur H, Sehgal IS, Bal A, Gupta N, Behera D, Das A, et al. Evolving epidemiology of lung cancer in India: Reducing non-small cell lung cancer-not otherwise specified and quantifying tobacco smoke exposure are the key. Indian J Cancer. 2017;54:285-90.
Mohan A, Garg A, Gupta A, Sahu S, Choudhari C, Vashistha V, et al. Clinical profile of lung cancer in North India: A 10-year analysis of 1862 patients from a tertiary care center. Lung India. 2020;37:190-7.
Milovanovic IS, Stjepanovic M, Mitrovic D. Distribution patterns of the metastases of the lung carcinoma in relation to histological type of the primary tumor: An autopsy study. Ann Thorac Med. 2017;12(3):191-8.
Lu T, Yang X, Huang Y, Zhao M, Li M, Ma K, et al. Trends in the incidence, treatment, and survival of patients with lung cancer in the last four decades. Cancer Manag Res. 2019;11:943-53.
Noronha V, Dikshit R, Raut N, Joshi A, Pramesh CS, George K, et al. Epidemiology of lung cancer in India: focus on the differences between non-smokers and smokers: a single-centre experience. Indian J Cancer. 2012;49(1):74-81.
Kulkarni RS, Anand AS, Parikh SK. Clinical and epidemiological profile of neuroendocrine tumors: An experience from a regional cancer center from Western India. South Asian J Cancer. 2019;8(3):198-202.
Agrawal A, Tandon R, Singh L, Kumar P, Pant H, Prakash S. Clinical profile of lung cancer in a tertiary care teaching hospital in north India with special reference to acceptance and outcome of treatment. J Pulmonol. 2018;2(1):4-8.
Doll R, Peto R, Boreham J. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ. 2004; 328: 1519.
Hymowitz N. Cigarette Smoking and Lung Cancer: Pediatric Roots. Lung Cancer Int. 2012;2012:790841.
Remen T, Pintos J, Abrahamowicz M, Siemiatycki J. Risk of lung cancer in relation to various metrics of smoking history: a case-control study in Montreal. BMC Cancer. 2018;18(1):1275.
Gupta D, Aggarwal A, Jindal S. Pulmonary effects of passive smoking: the Indian experience. Tob Induc Dis. 2002;1(2):129-36.
Krishna GG, Vahini G, Mrudula K, Asha T. An interesting study of lung cancers at a tertiary care centre. MedPulse Int J Med. 2019;10(2):56-8.
Das A, Krishnamurthy A, Ramshankar V, Sagar TG, Swaminathan R. The increasing challenge of never smokers with adenocarcinoma lung: Need to look beyond tobacco exposure. Indian J Cancer. 2017;54(1):172-7.