APIK Journal of Internal Medicine (Jan 2022)
Changing Trends of adenocarcinoma among other nonperipheral lung tumors in smokers and nonsmokers: A Tertiary care center's experience
Abstract
Background: Globally, modern lifestyles and the increasing incidence of lung cancer have changed the histopathological presentation of lung cancer to the point that it has reached epidemic proportions. It is well known that tobacco smokers are more prone to lung cancer. Nonsmokers are no exception. We conducted this study to determine if primary lung cancer is increasing in nonsmokers and examine the differences in clinicopathological patterns and disease staging between smokers and nonsmokers. Objective: (1) Comparing the occurrence of nonperipheral lung tumors in smokers and nonsmokers, (2) to determine whether bronchogenic carcinoma in smokers and nonsmokers exhibited the same histopathological shift, (3) a comparison of lung cancer in smokers and nonsmokers based on clinical and radiological findings. Materials and Methods: A prospective study in Pulmonary Medicine was conducted over 7 years from August 2012 to January 2020. All adult patients were screened with a detailed history and risk factors. Histopathological analysis was performed on patients with X-ray findings that appeared to be a mass or collapse caused by endobronchial growth, as well as on patients who were clinically, radiologically, and bronchoscopically suspicious for malignancy. Results: The study reports that out of the 386 cases of bronchogenic carcinoma, 295 (76.4%) were between 46 and 70 years of age, 282 (73.05%) were male, 250 (85%) smokers, and 104 (27%) females, 44 (14.9%) smokers. Smokers outnumbered nonsmokers by a ratio of 3.1:1. In 257 patients, fever was the most common symptom, followed by hemoptysis in 245 patients. Mass lesion was the most common radiological finding in 245 (63.4%) patients. Squamous cell carcinoma 123 patients (43.6%), Adenocarcinoma 107 patients (37.9%) and small cell carcinoma 35 patients (12.4%) were more common in males, while adenocarcinoma patients 48 (46.1%), squamous cell carcinoma 36 patients (34.6%) and small cell carcinoma 12 patients (11.5%) were more common in females. Conclusion: Majority of elderly patients have an increased risk of developing malignancy, as shown by this study. Smokers are still more likely to develop primary lung cancer than nonsmokers. Squamous cell carcinomas constituted a greater proportion of all histopathological types than adenocarcinomas. Adenocarcinomas are more likely to develop centrally during their later stages. The majority of adenocarcinoma patients presented at the terminal stage and were not smokers.
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