Demographic characteristics, clinical presentation, risk factors and pathological types of lung cancer: A prospective study

Background: Sparse published data are available regarding the epidemiology of lung cancer from Rayalaseema area of Andhra Pradesh State. Methods: Consecutive patients (n = 133) diagnosed to have and treated for lung cancer in medicine and medical oncology departments at our tertiary care teaching hospital in Tirupati, South India from March 2017 to June 2018, were prospectively studied. In all patients, risk factors, clinical manifestations, method of confirmation of diagnosis and histopathological and cytopathological types were documented. Results: Their mean age was 56.4 ± 11.2 years; there were 93 (70%) males. No risk factors were evident in 110 (83%) patients. Tobacco smoking (n = 69, 52%) (all males) was the most frequently evident risk factor; other risk factors included exposure to arsenic, silicone, passive smoking, environmental exposure, old pulmonary tuberculosis. Their mean Fagerstrom score for nicotine dependence was 8.2 ± 1.7. In 17% of patients, lung cancer was incidentally detected; the remaining 83% were symptomatic. Chief presenting complaints were cough (59%), dyspnoea (50%), haemoptysis (11%), amongst others. Cytopathological and histopathological diagnosis was done in 3% and 97%, respectively. Majority (n = 123, 92%) had non-small cell lung cancer (NSCLC) (60% adenocarcinoma and 17% squamous cell carcinoma), while small cell lung cancer was evident in 10 (8%). Most of them (52%) had presented in stage 4. Conclusions: Our observations suggest that tobacco smoking still remains the most common risk factor for lung cancer; majority of the patients had NSCLC, and most patients presented late with stage 4 disease.