Tobacco smoking and trends in histological subtypes of female lung cancer at the Cancer Hospital of the Chinese Academy of Medical Sciences over 13 years

Abstract

Background Lung cancer is the leading cause of cancer mortality among women in China, and incidence and mortality continue to rise despite the fact that smoking prevalence is very low among Chinese women. Aim This study investigated tobacco smoking and trends in histological subtypes of female lung cancer in a central cancer hospital in China. Methods Demographic, smoking history and histological information on female lung cancer patients diagnosed or treated from 2000 to 2012 was collected from the Cancer Hospital, Chinese Academy of Medical Science (CHCAMS). The classification of histological subtypes and clinical stages were conducted using the ICD‐O‐3 and Eighth AJCC Cancer Staging Manuals. Time‐trends of histological subtypes were analyzed based on annual percentage change (APC). Results Overall, 5870 female cases of lung cancer were included in the analysis. The number of female lung cancer patients increased from 509 (2000–2002) to 1744 (2011–2012). The most common histological type of lung cancer was adenocarcinoma (ADC) (72.93%), followed by small cell lung cancer (SCLC) (11.06%), squamous cell carcinoma (SCC) (8.38%) and other (7.63%). Among smokers, the proportion of SCC decreased from 40.5% to 23.7% (P = 0.005), while ADC increased from 35.7% to 50.7% (P = 0.009). In non‐smokers, ADC increased from 63.1% to 80.6% (P = 0.006) and SCC decreased from 13.6% to 4.5% (P = 0.016). Among SCC cases, smokers made up a larger proportion of early stage (I/II: 47.1%) compared with late stages (III, 34.3%; IV, 18.6%). Conclusion The number of female lung cancer patients has increased in CHCAMS. In both smoking and non‐smoking cases, the proportion of adenocarcinoma increased. Squamous cell carcinomas were more likely to be diagnosed in early stages among smokers.

Epidermal Growth Factor Receptor Mutation Status and Response to Tyrosine Kinase Inhibitors in Advanced Chinese Female Lung Squamous Cell Carcinoma: A Retrospective Study

“…From January 2013 to December 2018, a total of 4223 patients were diagnosed as advanced lung SCC in our hospital, of which 6.8% (288) were female, which was similar to the results of other studies (9.8%-27.0%) (30)(31)(32). It is well known that the incidence of SCC was closely related to smoking, but the smoking rate of Chinese women is relatively low, which was only 10.4% (16/154) from our observation (33)(34)(35)(36)(37). There might be some other reasons for the incidence of SCC in Chinese women.…”

Epidemiological characteristics and risk factors of lung adenocarcinoma: A retrospective observational study from North China

“…The results showed that lung adenocarcinoma was more common in never-smokers compared to ever-smokers (72% vs. 65%) and more common in women compared to men (70% vs. 65%) (29). One study in China showed that though the proportion of lung adenocarcinoma increased in smokers and non-smokers, lung adenocarcinoma was more common in non-smokers (30). However, the result from a national health examination program in Korea was inconsistent with that of this study.…”

Cigarette smoke-induced LKB1/AMPK pathway deficiency reduces EGFR TKI sensitivity in NSCLC

“…The changes in the design and manufacture of cigarette filter have been documented to lead to a shift in the histology from SCC to adenocarcinoma subtypes of lung cancer due to higher exposure and sensitivity of peripheral lung cells to mutagens and carcinogens [ 7 , 8 ]. The association between cigarette smoking and development of lung adenocarcinoma increased gradually, and exposure to cigarette smoke not only promotes cancer cell progression and stemness but also reduces the sensitivity of NSCLC cells to EGFR TKI through several potential mechanisms, including EGFR hyperactivation, c-MET overexpression, and ABCG2-depednent drug efflux [ 9 – 12 ].…”