Pulmonary and extrapulmonary manifestations in delayed diagnosis of lung cancer in Bangladesh.

Study on the mode of presentation among 3815 lung cancer patients showed that 3608 (75%) presented with respiratory symptoms and 953 (25%) with extrapulmonary symptoms. Of the respiratory symptoms, cough was the complaint in 1940 (51%), features of superior vena cava obstruction (SVO) in 451 (12%), hemoptysis in 332 (9%), and dyspnea in 139 (4%). Analysis of extrapulmonary symptoms showed 348 (9%) patients appeared with complaints of bone pain, 273 (7%) with pyrexia of unknown origin (PUO). 235 (6%) with enlarged cervical glands, 39 (1%) with hoarseness, 29 (0.76%) with arm pain, 14 (0.36%) with jaundice, and the remaining 15 (0.39%) patients, categorized as miscellaneous group, presented with heterogeneous symptoms. In our study, cough, SVO, hemoptysis, dyspnea, bone pain, enlarged cervical glands, and PUO were the commonest mode of presentation and significantly higher than earlier reports (P less than 0.001). Our results may be explained by patient and/or physician delay due poor awareness of high-risk symptoms of lung cancer.