Cases Of Lung Cancer In Women Research Articles

Epidemiological changes in the histological subtypes of 35,018 non-small-cell lung cancer cases in Brazil

ObjectivesRegarding the fatality rates stemming from various existing forms of cancers worldwide, lung cancer (LC) is ranked as the main cause of death amongst those who suffer from cancer. Although the epidemiological, clinical, and histological profile of patients with this type of cancer is largely unknown, Brazil has made tremendous efforts to generate data for supporting healthcare policies concerning lung cancer. Taking these factors into account, this study aims to analyse the epidemiological, clinical, and histological profiles of patients with non-small-cell lung cancer (NSCLC) in Brazil. Material and methodsFor this study, a cross-sectional epidemiological study was conducted to nationally analyse patient’s data within the cancer hospital registries found in the National Cancer Institute (INCA) and the São Paulo Cancer Foundation (FOSP) between 2000 and 2011. ResultsA total of 35,018 patients diagnosed with NSCLC in Brazil between 2000 and 2011 were analysed. The analysis demonstrated the occurrence of an epidemiological shift, related to the most prevalent histological type of NSCLC in the study population from 2003. The shift resulted in a higher percentage of adenocarcinoma (43.3%) over squamous cell carcinoma (36.5%). Additionally, there was a significant increase in both the number of cases of LC in women and in the rates of patients diagnosed with metastatic disease. ConclusionThe use of filtered cigarettes since the 60’s and the increase in the number of LC cases in women, were one of the causes for the switch in the histological profile of NSCLC in Brazil. Consequently, adenocarcinoma is now the predominant type of cancer detected. Late diagnosis is a hallmark sign.

Abstract 5479: Somatic driver mutations among never smoking female lung cancer cases in China identify unique mutation pattern that may be associated with household coal burning

Abstract Globally, about 53% of lung cancer cases in women and 15% of lung cancer cases in men are not attributable to active tobacco use, making lung cancer in never smokers the seventh leading cause of cancer death. Experimental and epidemiological evidence suggest that lung cancer in never smokers has unique risk factors, clinical features, and histological distributions as compared to those lung cancer cases attributed to tobacco smoking. In general, lung cancer in never smokers presents predominately as adenocarcinoma and in females. The lung cancer rate among females in Xuanwei, China is among the highest in the world for nonsmoking females, and has been attributed to indoor air pollution from domestic fuel combustion, particularly from bituminous coal. To further explore the clinical and histological aspects of lung cancer in Xuanwei, we collected formalin-fixed paraffin embedded (FFPE) tissue samples from a series of 76 female lung cancer cases. The mean age of the patients was 47.7 years old (±9.2 years). Expert consensus review found 54 (71%) of the female lung cancer cases were adenocarcinomas (ADCs), 11 (14.5%) were squamous cell carcinomas (SCCs), 1 (1.3%) was an adenosquamous carcinoma (ADSC), 8 (10.5%) were large cell carcinomas, and 2 (2.7%) were other subtypes. We then used two multiplexed assays to detect in DNA from FFPE tissue more than 40 recurrent mutations in nine genes relevant to existing and emerging targeted lung cancer therapies among subjects who were confirmed never smoking female lung cancer cases (32 ADCs, 7 SCCs, 1 ADSC). These assays include amplification of DNA through Applied Biosystem's SNaPshot technology to detect 38 different recurrent somatic point mutations in 8 driver genes (EGFR, KRAS, BRAF, NRAS, PIK3CA, MEK1, AKT1, and PTEN) and a PCR-based sizing assay that assesses for EGFR exon 19 deletions, EGFR exon 20 insertions, and HER2 exon 20 insertions. We detected 15 EGFR mutations [E20-6bp-ins. (n=1); EGFR_19-15bpDel (n=4); EGFR_G719A_2156G>C (n=2); EGFR_G719C_2155G>T (n=3); EGFR_G719S _2155G>T (n=1); EGFR_G719S_2155G>A (n=1); EGFR_L858R_2573T>G (n=2); EGFR L861Q_2582T>A (n=1)] in 12 ADCs and 2 SCCs. Six KRAS mutations, all of which were KRAS G12C_34G>T, were detected in 5 ADCs and 1 SCC. EGFR and KRAS mutations were mutually exclusive and no mutations were observed for BRAF, NRAS, PIK3CA, MEK1, HER2, AKT1, or PTEN. The high percentage of samples with KRAS mutations (15.0% overall; 15.6% ADCs; 14.3% SCCs) in our series is of interest, primarily because KRAS mutations are reportedly more rare in other populations from Asia (∼5%) and populations of never smokers from Asia (∼2%). Given that all subjects with KRAS mutations burned coal indoors for heating and cooking, our findings may provide new insights into the pathogenesis of lung cancer among never smoking females exposed to indoor air pollution from coal. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5479. doi:1538-7445.AM2012-5479

Variation in incidence of breast, lung and cervical cancer and malignant melanoma of skin by socioeconomic group in England

BackgroundCancer incidence varies by socioeconomic group and these variations have been linked with environmental and lifestyle factors, differences in access to health care and health seeking behaviour. Socioeconomic variations in cancer incidence by region and age are less clearly understood but they are crucial for targeting prevention measures and health care commissioning.MethodsData were obtained from all eight English cancer registries for patients diagnosed between 1998 and 2003, for all invasive cases of female breast cancer (ICD-10 code C50), lung cancer (ICD-10 codes C33-C34), cervical cancer (ICD-10 code C53), and malignant melanoma of the skin (ICD-10 code C43). Socioeconomic status was assigned to each patient based on their postcode of residence at diagnosis, using the income domain of the Index of Multiple Deprivation 2004. We analysed the socioeconomic variations in the incidence of breast, lung and cervical cancer and malignant melanoma of the skin for England, and regionally and by age.ResultsIncidence was highest for the most deprived patients for lung cancer and cervical cancer, whilst the opposite was observed for malignant melanoma and breast cancer. The difference in incidence between the most and the least deprived groups was higher for lung cancer patients aged under 65 at diagnosis than those over 65 at diagnosis, which may indicate a cohort effect. There were regional differences in the socioeconomic gradients with the gap being widest for lung and cervical cancer in the North (North East, North West and Yorkshire and Humberside) and for malignant melanoma in the East and South West. There were only modest variations in breast cancer incidence by region. If the incidence of lung and cervical cancer were decreased to that of the least deprived group it would prevent 36% of lung cancer cases in men, 38% of lung cancer cases in women and 28% of cervical cancer cases. Incidence of breast cancer and melanoma was highest in the least deprived group, therefore if all socioeconomic groups had incidence rates similar to the least deprived group it is estimated that the number of cases would increase by 7% for breast cancer, 27% for melanoma in men and 29% for melanoma in women.ConclusionNational comparison of socioeconomic variations in cancer incidence by region and age can provide an unbiased basis for public health prevention and health commissioning. Decreasing inequalities in incidence requires the integration of information on risk factors, incidence and projected incidence but targeted public health interventions could help to reduce regional inequalities in incidence and reduce the future cancer burden.

Trends in lung cancer incidence in Sweden with special reference to period and birth cohorts.

Sweden has one of the largest population-based cancer registers in the world that provides an opportunity to examine the trend of lung cancer incidence during a 35-year period. The primary aim of the present study was to estimate the effects of birth cohort, year of diagnosis (period), and age on the time trends of lung cancer incidence rates, and to analyze the gender-specific incidence of different histopathological types of lung cancer. Among men the age-standardized incidence rate increased steadily up to 1982, when a peak of 49 cases per 100,000 person-years was reached. Among women the incidence rate was lower and showed a monotonic increase throughout the observation period. The fastest rate of increase was noted among the youngest women. In women, but not in men, there was a steady increase in risk with each successive birth cohort. For both sexes there were large changes in the histopathological distributions of cases. The most notable was a major increase in adenocarcinomas. The overall age-adjusted incidence rate of lung cancer in Sweden has stabilized in men during the past two decades while rates are still increasing in women. In view of the continued high prevalence of smoking among young women, a future definite increase in the overall number of lung cancer cases in women can be expected.

Female lung cancer.

Female lung cancer death rates increased by more than 550 percent between 1950 and 1991. In 1986 lung cancer surpassed breast cancer to become the leading cause of cancer death in women in the United States. The lung cancer epidemic is primarily attributable to cigarette smoking, which is responsible for at least 80% of the disease in women. There are gender differences in the distribution of lung cancer by histologic type, even controlling for smoking, and some data suggest greater female than male susceptibility to lung cancer at a given level of smoking. Exposure to environmental tobacco smoke increases risk of lung cancer in nonsmoking women. Family history of lung cancer, personal history of lung disease (e.g. asthma, chronic bronchitis, pneumonia, or tuberculosis), and a history of radiotherapy also appear to be associated with increased risk. Data specific to women on the role of household radon exposures or of specific occupational or environmental exposures are relatively sparse and inconsistent. Finally, many studies have reported a decreased risk of lung cancer in individuals who consume high levels of fruits and vegetables; however, clinical trials fail to support a beneficial effect of beta-carotene supplementation. Since cigarette smoking accounts for the vast majority of lung cancer cases in women, efforts to prevent adolescent girls from starting to smoke and to encourage cessation among established smokers have the greatest potential for reducing the female lung cancer burden.

Saturated fat intake and lung cancer risk among nonsmoking women in Missouri.

Although the vast majority of lung cancer cases in women are caused by smoking, 9%-20% of cases occur in nonsmokers. Previous epidemiologic research on the relationship between lung cancer and diet has shown that fruit and vegetable consumption may confer a protective effect against lung cancer, while a diet rich in cholesterol and fat may increase risk. The purpose of this case-control study was to examine the effects of a broad range of dietary factors on the risk of lung cancer in a population of nonsmoking white women 30-84 years of age. A telephone-administered questionnaire was used to determine and/or verify eligibility with regard to age, gender, race, and smoking status. In a second interview at the participant's home, a widely used food frequency questionnaire was filled out, and logistic regression was subsequently used to analyze the responses. We obtained dietary information on 429 case subjects who had a diagnosis of lung cancer reported to the Missouri Cancer Registry between June 1, 1986, and June 1, 1991, and 1021 control subjects. If a case subject had died or was too ill to be interviewed, next-of-kin familiar with the woman's diet were interviewed instead. Of the 429 women with lung cancer, 211 (49%) had lung adenocarcinoma. A strongly increasing trend in lung cancer risk was observed with increased saturated fat consumption among these non-smoking women; the relative risk was more than sixfold greater for the highest quintile of consumption than for the lowest quintile. The effect of saturated fat was more pronounced for adenocarcinoma than for other cell types. Weekly servings of beans and peas were significantly related to decreased lung cancer risk, while citrus fruit and juice showed a twofold increase in risk; this trend was also significant. By focusing on non-smoking women with lung cancer, including a large number with adenocarcinoma, we observed a clear association with saturated fat consumption that may have been masked in earlier studies of lung cancer involving a high percentage of smokers.