Temporal Changes in Lung Cancer: A 10-year Study in a Chest Hospital

Background and Aim. No prospective, wide-scale study on lung cancer (LC) exists in Turkey. We aimed to determine prospectively epidemiologic features, histologic types, stages and temporal changes in LC in the Aegean Region of Turkey. This is the first prospective and largest LC study in Turkey. Methods. A hospital-based study was conducted on LC cases diagnosed between 1994 and 2004 at a tertiary referral hospital for thoracic medicine and surgery in Izmir, Turkey. The study was divided into two 5-year periods to determine temporal changes. Results. Of 13,344 patients with pathologically confirmed LC, 93.1% was male. The mean age was 61.35±0.08 (59.5% between 41-65). The majority (82.5%) were smokers or ex-smokers. There was a 13.87% general rise in smoking rate, predominantly in females. LC incidence increased by 38% from 1994-1999 (42%) to 2000- 2004 (58%); the contributive increases were 35.5% in males, and 77.5% in females. Frequent types were squamous cell carcinoma (24.7%), small cell carcinoma (SCLC) (14.2%) and adenocarcinoma (13.2%). Adenocarcinoma in the younger group (<40), females or nonsmokers, and squamous cell carcinoma in the older group, males or smokers were the leading types. Nonsmall cell lung carcinoma (NSCLC) was mostly diagnosed at stages IIIB (36.7%) and IV (37%) whereas SCLC at limited stage (59.1%). Conclusion. The majority of the LC patients are over 40 years old, current or ex-smokers, or with squamous cell carcinoma. There is a general rise in smoking rate with a female predominance. The most common type is squamous cell carcinoma in males, and adenocarcinoma in females. NSCLC is diagnosed more frequently at advanced stage but SCLC at limited stage.