Lung cancer incidence in never smokers in the Southeast of Brazil: 10 years analysis.

Abstract

e13571 Background: Lung cancer is a leading cause of cancer death worldwide. In Brazil, the Ministry of Health estimated an absolute incidence of 30,200 cases of lung cancer in 2020. Eighty-five percent of diagnosed cases are associated with consumption of tobacco products. Although smoking remains the predominant cause, lung cancer in never smokers is an increasingly prominent public health problem. However, data on this topic, particularly lung cancer incidence rates in developing countries in never smokers are limited. Methods: The data presented in this work correspond to the period from 2007 to 2017 and were extracted from the database of the Hospital Cancer Registry of the Evangelical Hospital of Cachoeiro de Itapemirim (RHC / HECI) through SisRHC, a computerized database management tool for Hospital Cancer Records. Results: Of the 494 patients who were diagnosed with lung cancer aged 18 years or over, 395 (80%) had complete information on a history of tobacco use, of which 68 patients denied smoking. Based on data from 68 patients, the years 2011 and 2012 had the lowest incidence, 6%, of non-smokers with lung cancer. 2009 and 2007 were the years with the highest incidence, 24 and 33% respectively. In the remaining years, the percentage varied between 15 and 23%. Regarding gender, 47 (69%) of the cases were women and 21 (31%) were men. Adenocarcinoma without a specific origin (NOS) was the most frequent histological type in non-smoking patients, with 33 (48.5%) of the cases, followed by malignant neoplasia 10 (14.7%), squamous cell carcinoma NOS 8 (11, 8%) and NOS carcinoma 7 (10.3%), the types of NOS large cell carcinoma, NOS small cell carcinoma, NOS papillary carcinoma, NOS bronchioloalveolar adenocarcinoma and adenosquamous carcinoma account for 10 (14.7%) cases. Analyzing the clinical staging (CE) at the time of diagnosis, 1 (1.5%) had EC 1, 4 (5.9%) EC 2, 12 (17.6%) EC 3, 42 (61.8%) EC 4 and 9 (13.2%) had no reports of staging. The median incidence rate was 17%, confirming that smoking remains the biggest cause of lung cancer, and reinforcing the need for more comprehensive epidemiological analyzes for this population. As the data can reach even higher percentages, as the information is provided by patients, without an available reliability assessment method. Conclusions: Lung cancer in never smokers is a major public health problem and further exploration of its patterns of incidence, etiology and biology is needed.