Hematology-Oncology, Staten Island University Hospital, Staten Island, NY, USA.
Hematology-Oncology, Nebraska Medical Ctr, Omaha, NE, USA.
Int J Gen Med. 2014 Jul 2;7:333-7. doi: 10.2147/IJGM.S55806. eCollection 2014.
The incidence of lung cancer in the United States decreased by 1.8% from 1991 to 2005 while it increased by 0.5% in females. We assessed whether nonsmokers afflicted with lung cancer at Staten Island University Hospital are disproportionately female in comparison to national averages. We also evaluated different factors including race, histology, and body mass index (BMI) in correlation with smoking history.
A retrospective chart review was conducted from 2005 to 2011 on 857 patients. Patients were divided into two groups according to their smoking status: current or ever-smokers, and former or never-smokers. A chi-square test for categorical data and multivariate logistic regression analyses was used to study the relation between BMI and the other clinical and demographic data.
Forty-nine percent of patients were men and 51% were women with a mean age at diagnosis of 67.8 years. Current smokers were most common (50.2%) followed by ever-smokers (18.2%), former smokers (15.8%) and never-smokers (15.6%). Forty eight percent had stage IV lung cancer upon presentation. Never-smokers with lung cancer were 24 times more likely to be females. However, the proportion of female former smokers (31.6%) was lower than the proportion of male former smokers (68.4%) (P=0.001). There was no significant association between American Joint Committee on Cancer (AJCC) stage, sex, race, and histological type in the two smoking groups. Current/ever-smokers tended to be younger at age of diagnosis (P=0.0003). BMI was lower in the current/ever-smokers (26.8 kg/m(2)) versus former/never-smokers (28.8) in males (P=0.0005). BMI was significantly higher in males (30.26) versus females (25.25) in the never-smoker category (P=0.004). Current smokers, compared to others, had a lower BMI in males (26.4 versus 28.3; P=0.0001) and females (25.5 versus 26.9; P=0.013) but the mean BMI for all groups was in the overweight/obese range.
Our population of lung cancer patients although demographically distinct, reflects a similar proportion of afflicted nonsmokers to the national population. Smoking is a major risk factor for lung cancer, but there is also a possible direct correlation with BMI that would support obesity as a potential risk factor for lung cancer.
从 1991 年到 2005 年，美国的肺癌发病率下降了 1.8%，而女性的发病率则上升了 0.5%。我们评估了在史坦顿岛大学医院（Staten Island University Hospital）被诊断患有肺癌的非吸烟者，与全国平均水平相比，女性是否不成比例地多。我们还评估了不同的因素，包括种族、组织学和体重指数（BMI）与吸烟史的关系。
对 2005 年至 2011 年的 857 名患者进行了回顾性图表审查。根据患者的吸烟状况将其分为两组：当前吸烟者或曾吸烟者，以及以前吸烟者或从不吸烟者。采用卡方检验对分类数据和多变量逻辑回归分析进行了研究，以研究 BMI 与其他临床和人口统计学数据之间的关系。
49%的患者为男性，51%为女性，平均诊断年龄为 67.8 岁。当前吸烟者最为常见（50.2%），其次是曾吸烟者（18.2%）、以前吸烟者（15.8%）和从不吸烟者（15.6%）。48%的患者在就诊时为 IV 期肺癌。从未吸烟的肺癌患者中，女性是男性的 24 倍。然而，女性前吸烟者（31.6%）的比例低于男性前吸烟者（68.4%）（P=0.001）。在两组吸烟者中，美国癌症联合委员会（AJCC）分期、性别、种族和组织学类型之间无显著关联。当前/曾吸烟者的诊断年龄（P=0.0003）更年轻。男性中，当前/曾吸烟者的 BMI 低于以前/从不吸烟者（26.8kg/m2 对 28.8）（P=0.0005）。男性中从不吸烟者的 BMI 显著高于女性（30.26 对 25.25）（P=0.004）。与其他人群相比，男性（26.4 对 28.3；P=0.0001）和女性（25.5 对 26.9；P=0.013）的当前吸烟者 BMI 较低，但所有组的平均 BMI 均处于超重/肥胖范围。
我们的肺癌患者人群在人口统计学上存在差异，但与全国人口相比，患有肺癌的非吸烟者比例相似。吸烟是肺癌的主要危险因素，但也可能与 BMI 有直接关联，这支持肥胖可能是肺癌的一个潜在危险因素。
