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A. Das



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    P1.01 - Poster Session with Presenters Present (ID 453)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Epidemiology/Tobacco Control and Cessation/Prevention
    • Presentations: 1
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      P1.01-055 - Clinicoepidemiological Trends of Lung Cancer from a Premier Regional Cancer Centre in South India (ID 5901)

      14:30 - 15:45  |  Author(s): A. Das

      • Abstract
      • Slides

      Background:
      Lung Cancer is one of the leading causes of morbidity and mortality worldwide. It is most commonly attributed to smoking; a smaller proportion is attributed to occupational exposure. However, an earlier published study by Krishnamurthy et al 2012 from the authors institute reported the increasing trends of “Nonsmoking associated lung cancers” in the Indian subcontinent. A larger prospective study aimed at validating the initial findings was planned and this formed the basis of the present study.

      Methods:
      All consecutive histologically confirmed patients with lung cancer who presented to the outpatient department over a year (November 2014 to October 2015) were included in this current prospective study. A comprehensive questionnaire administered by a trained social worker captured all the demographic details including age, sex, occupation, smoking habits including exposure to second hand smoke, type of cooking fuel, histopathology and stage at presentation among others. (And later analyzed by SPSS Version 22.0)

      Results:
      713 patients presented with clinico-radiologicaly suspicious findings of lung cancer in the said period. A pathological confirmation of lung cancer could be ascertained in 495 patients and this cohort was further analyzed. The median age of presentation was 58 years; the male to female ratio was approximately 2.5:1. 52.12 % patients were nonsmokers. Adenocarcinoma (63 %) was the predominant histology. Nonsmokers, both among men (p=0.02) and women (0.001) presented more frequently with adenocarcinoma histology. Interestingly, 84.9 % (45/53) rural and 76.1 % (19/25) urban women who were nonsmoker reported exposure to indoor air pollution (second hand smoke/fuel used for cooking purposes) which was significantly associated with adenocarcinoma histology. (p=0.01) A majority of the patients (69.1 %) presented with clinical stage IV. (7[th] edition TNM) Nearly 60% of patients presented in ECOG performance status 3-4, nonsmokers incidentally presented in a better performance status than smokers (p = 0.017). 53% of the patients unfortunately were deemed suitable only for best supportive care. Only 97 patients (19.6 %) were offered potentially curative treatment and radical surgery accounted for < 3 % of the overall management.

      Conclusion:
      This prospective study validated our initial observation of the increasing trends of lung cancers among nonsmokers. Further, this study also reflected the global trend of rise in adenocarcinoma histology. These findings in a larger perspective will help clinicians better understand the magnitude and the direction of the lung cancer epidemic and also aid policymakers in better channelizing the resources for effective public health interventions.

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