Prevalance of lung cancer in non-smokers in kashmir

Abstrakt

BACKGROUND: Lung cancer is a major health issue in females. With exposure to environmental tobacco smoke, biomass and cooking fumes acting as main risk factors for the development of this disease.

OBJECTIVES:

1)To elucidate the etiological/ risk factor profile of non-smokers female lung cancer patients presenting to a tertiary care hospital.

 2)To find the prevalence and incidence of lung cancer in non-smokers.

3)To study the clinical profile of non-smoker lung cancer patients.

PARTICIPANTS: Confirmed cases of Ca lung by HPE regardless of provenance tumour tissue, for example, bronchoscopy guided biopsy, surgical lung biopsy or biopsy of metastatic site. Only non-smoker female patients diagnosed with lung cancer are taken.

Study Design: This study was an observational cross-sectional study.           

 METHODS: For prospective study Standardized questionnaire for all the diagnosed patients on age, residence, occupation and education was obtained to collect demographic data.

The study protocol included information regarding the onset and progression of symptoms.

The questionnaire on environmental tobacco smoke gathered information regarding exposure at home, work place and at other public spaces   History regarding exposure to dust, pesticides,  occupation, cooking practices and  history of lung disease, family history of lung cancer was asked from the patient.For retrospective data ,informationregarding above mentioned risk factors will be collected from the RCC SKIMS. 

RESULTS: Most cases were in age group of 60 to 70 years.Among non smokers cancers 3.1 % were non smoker females lung cancer.Among total lung cancer 11.8%  were non smoker female lung cancer.Among cases 37.6%  had exposure to second hand smoke. 20.8% cases had biomass smoke exposure.10.9% cases had exposure to cooking fumes. Out of 101 cases,  24 cases had received treatment for pneumonia in past.While as 5 cases had received treatment for bronchial asthma. 79.2% cases had cough, 64.4% cases had breathlessness, and 29.7% cases had hemoptysis as main symptoms. Adenocarcinoma was most common type with 65.3%. Second most common histopathological type was squamous cell carcinoma.

CONCLUSION:  Lung cancer in non-smokers females occurs at advanced age with majority of cases above 40 years. The prevalence of lung cancer among non-smokers females is consistent with results from European studies.  Most common risk factor was environmental tobacco smoke followed by biomass smoke.Presence of previous lung disease confers a risk for development of lung cancerin never smokers.Occupational exposure was less obvious in our region. Most common symptom was cough .

 IMPLICATIO:S Lung cancer is a major health issue in females. With exposure to environmental tobacco smoke, biomass and cooking fumes act as main risk factors for development of this disease. The incidence of lung cancer in non-smoker women is expected to increase due to extensive and successful smoking prevention and cessation programs. Strong efforts to curb smoking at home as well as public places is needed. A concerted effort is needed to identify the factors responsible for lung cancers arising in never smokers women, so that we can understand its biology, learn how to diagnose the disease earlier, and treat it in a rational manner.