Shirgaonkar Rohit, Mohapatra Prasanta R, Panigrahi Manoj K, Mishra Pritinanda, Bhuniya Sourin, Sarkar Subho, Girija Aswathy, Shaik Afshan, Mohanty Swadesh, Moorthy Akshaya
Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND.
Pathology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND.
Cureus. 2024 Mar 12;16(3):e56024. doi: 10.7759/cureus.56024. eCollection 2024 Mar.
INTRODUCTION: The majority of lung cancers are caused by tobacco use, which is linked to lung tumors of all major histological types. A considerable fraction of lung cancer cases, the vast majority of which are adenocarcinomas, occur in "never smokers," who are characterized as having smoked fewer than 100 cigarettes in their lives. The primary objective was to assess risk factors for lung cancer in non-smokers. In contrast, secondary objectives included evaluating histological subtype, staging, and performance status and exploring associations between risk factors and common driver mutations. MATERIAL AND METHODS: The study was a single-center, observational, case-control study done at All India Institute of Medical Science, Bhubaneswar, India that focused on non-smokers with lung cancer. It included 145 cases and 297 controls, with statistical analyses such as chi-square tests and logistic regression used to assess associations between risk factors and lung cancer, considering factors such as socioeconomic status, body mass index (BMI), occupation, outdoor and indoor air pollution, personal habits, and medical history. RESULTS: The study, comprising 145 lung cancer cases in non-smokers and 297 controls, found that 92.4% (134/145) of cases had adenocarcinoma, 6.9% (10/145) had squamous cell carcinoma, and 0.7% (1/145) had small cell carcinoma. Significant associations were observed for high-risk occupations, indoor biomass use without proper ventilation, low BMI, and family history of lung cancer. Specific pre-existing lung conditions like old pulmonary tuberculosis and asthma were linked to increased and decreased odds of developing lung cancer, respectively. Environmental factors, living near heavy industry, and dietary habits showed significant associations. A significant association was not found between the driver mutations and the risk factors studied. CONCLUSION: This single-center study sheds light on significant risk factors influencing lung cancer development among non-smokers. The predominant occurrence of adenocarcinoma and associations with high-risk occupations, indoor biomass exposure, low BMI, and family history emphasize the multifaceted nature of non-smoking-related lung cancer. The findings underscore the importance of comprehensive risk assessment and targeted preventive strategies in this population.
引言:大多数肺癌是由吸烟引起的,这与所有主要组织学类型的肺部肿瘤有关。相当一部分肺癌病例(其中绝大多数是腺癌)发生在“从不吸烟者”中,这些人被定义为一生中吸烟少于100支。主要目的是评估非吸烟者患肺癌的风险因素。相比之下,次要目的包括评估组织学亚型、分期和功能状态,以及探索风险因素与常见驱动基因突变之间的关联。 材料与方法:该研究是在印度布巴内斯瓦尔全印医学科学研究所进行的一项单中心、观察性病例对照研究,重点关注非吸烟肺癌患者。研究包括145例病例和297例对照,采用卡方检验和逻辑回归等统计分析方法来评估风险因素与肺癌之间的关联,同时考虑社会经济地位、体重指数(BMI)、职业、室外和室内空气污染、个人习惯以及病史等因素。 结果:该研究纳入了145例非吸烟肺癌患者和297例对照,发现92.4%(134/145)的病例为腺癌,6.9%(10/145)为鳞状细胞癌,0.7%(1/145)为小细胞癌。观察到高风险职业、室内使用生物质燃料且通风不良、低BMI以及肺癌家族史之间存在显著关联。特定的既往肺部疾病,如陈旧性肺结核和哮喘,分别与患肺癌几率的增加和降低有关。环境因素、居住在重工业附近以及饮食习惯也显示出显著关联。未发现驱动基因突变与所研究的风险因素之间存在显著关联。 结论:这项单中心研究揭示了影响非吸烟者肺癌发生的重要风险因素。腺癌的主要发生情况以及与高风险职业、室内生物质暴露、低BMI和家族史的关联强调了非吸烟相关肺癌的多面性。研究结果强调了在这一人群中进行全面风险评估和针对性预防策略的重要性。
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