"Blasts" from the Past: Lung Cancer in Cape Breton

Abstract

Background: With the advent of molecular testing and its role in determining appropriate therapy for non small cell lung cancer (NSCLC), particularly adenocarcinoma, we reviewed charts from the Cape Breton Cancer Centre from 2011 to 2013, to determine availability of tissue for molecular testing. We were also interested in recording the distribution of histologic subtypes of NSCLC in this population. Methods: A detailed chart review was carried out exploring relative rates of various histologies, smoking history, type of diagnostic procedure carried out, availability of tissue for further testing, and need for re-biopsy. When necessary for diagnostic clarification, pathology review was done. Results: For convenience and to prevent selection bias, one hundred consecutive lung cancer cases coded as NSCLC by the provincial cancer registry were reviewed. The highest percentage was squamous cell (40%), followed by adenocarcinoma (29%), NSCLC not otherwise specified (18%), large cell (6%), neuroendocrine (4%), and adenosquamous (3%). These figures are out of line with typical North American figures and are similar to findings from the 1950s and 1960s. Conclusion: This study demonstrated more than expected squamous cell NSCLC and less adenocarcinoma. Environmental and lifestyle issues may be implicated. With recent environmental changes and the enactment of an anti-smoking bylaw in Cape Breton, we expect to see these figures change to those more typical for North America.