Lung cancer is one of the most common malignancy worldwide, accounting for 13% of all new cancer cases. Even though tobacco smoking is the most important risk factor,global estimates indicate that about 300,000 annual lung cancer deaths are not due to tobacco use. In Brazil, the Instituto Nacional de Câncer (INCA, Brazilian National Cancer Institute) estimated a total of 625,000 new cancer cases in 2020, of which 17,760 cases of primary lung malignancies. Lung cancer is the second most incident cancer among men and the fourth most incident cancer among women in the country. Trends in lung cancer mortality in Brazil reflect the epidemiological model of tobacco-related mortality. But we also have begun to see the rising of cancer non tobacco-related, especially in women. To date, there have been few published studies focusing on clinical, epidemiological, and survival patterns in Brazilian never-smoker patients. We performed a retrospective analysis of registry data from the Hospital Evangelico de Cachoeiro de Itapemirim (HECI) information system Sistema de RegistroHospitalar de Cancer (SISRHC) from 2008 to 2017. There were 426 cases of lung cancer cases during this period. The data were analyzed in terms of gender, age, history of tobacco use, stage and histology. Of the 426 patients analyzed, 269 (63.14%) were men and 157 (36.86%), women.The epidemiological analysis by gender revealed that 119 women patients were smokers (75,80%) and 38 (24.20%) non-smokers. Specifically in non-smokers, 21 (55.23%) had adenocarcinoma, 10 (26.36%) had carcinoma and 7 (18.41%) had other histology types. Most women (22/57.90%) were diagnosed at stage IV, 6 (15.80%) at stage III and 3 (7.89%) atearly stages. Regarding women age at diagnosis, 5 (13,19%) patients were aged under 49 years; 18 (47,37%) between 50 and 69 years; and 15 (39,47%) over 70 years. Regarding male gender data, 108(40.14%) patients were smokers and 20 (7.43%) non-smokers. Specifically in non-smokers, 8 (40%) had adenocarcinoma, 5 (25%) squamous cell carcinoma and 7 (35%) had other histology types. Among the men,11 (55%) were diagnosed at stage IV, 5 at stage III (25%) and 2 (10%) at early stages. Regarding menage at diagnosis, 4 (20%) patients were aged under 49 years; 10 ( 50 %) between ages 50 and 69 years; and 6 ( 30 % ) over 70 years. We observed a striking incidence of lung cancer in women without history of smoking, aged over 50 years old, with adenocarcinoma histology and advanced staging at diagnosis. Therefore, developing countries like Brazil must treat this as a public health issue needing further exploration of its patterns, biology and etiology.
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