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Increasing Incidence of Non-Smoking Lung Cancer: Presentation of Patients with Early Disease to a Tertiary Institution in the UK

WCLC 2015

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Increasing Incidence of Non-Smoking Lung Cancer: Presentation of Patients with Early Disease to a Tertiary Institution in the UK

DENVER, Colo. – Lung cancer researchers in Great Britain discovered that the incidence of people who never smoked and were diagnosed with non-small cell lung cancer (NSCLC) increased from 13 percent to 28 percent in a seven-year period. The research was presented today by Dr. Eric Lim, Royal Brompton & Harefield NHS Foundation Trust, London at the 16th World Conference on Lung Cancer (WCLC) hosted by the International Association of the Study of Lung Cancer (IASLC).

Lung cancer in never-smokers is recognized as a distinct entity and many of these people present to doctors with more advanced stage of diseases. Lim aimed to define the incidence and clinical features of never-smokers presenting sufficiently early for surgery to determine if it is possible to identify patients at risk.

To accomplish this, Lim and his colleagues retrospectively analyzed data from a prospectively collected database of patients who underwent surgery at his hospital. The incidence was defined as number of never-smokers versus current and ex-smokers by year. Clinical features at presentation were obtained and collated as frequency (percentage).

A total of 2,170 patients underwent lung cancer surgery from March 2008 to November 2014. The annual incidence of developing lung cancer in never-smokers increased per year from 13, 15, 18, 19, 20, 20 to 28 percent respectively, attributable to an absolute increase in number and not a change in the ratio of never smokers to current and ex-smokers.

A total of 436 (20 percent) patients were never smokers. The mean age at presentation was 60 years and 295 (67 percent) were female. Good lung function was observed with mean predicted FEV1 of 90 percent and FVC of 97 percent. The majority of histological types were adenocarcinoma 54 percent and carcinoid 27 percent. The main presenting features were non-specific cough in 142 (34 percent), chest infections in 75 (18 percent) and hemoptysis in 46 (11 percent). Recurrent chest infections were the predominant presenting symptom of central carcinoid tumors (30 versus 15 percent; P=0.004). A total of 59 (14 percent) were detected on incidental chest film, 127 (30 percent) on incidental CT, 32 (7 percent) on incidental PET/CT and 4 (1 percent) on incidental MRI.

Lim and his colleagues observed more than double the annual incidence of never smokers presenting with NSCLC in the last seven years, increasing from 13 to 28 percent. They hypothesize that this is representative of the United Kingdom as their center has one of the highest surgical volumes in the country.

Lim’s team identified a number of non-specific symptoms these patients presented with which suggests that imaging could play a more important role in diagnosing these patients at an earlier stage.

“Clearly, this research suggests that efforts need to be expended on early detection of lung cancer in this increasing cohort without any observable risk factors,” Lim said.

About the WCLC:

The WCLC is the world’s largest meeting dedicated to lung cancer and other thoracic malignancies, attracting more than 7,000 researchers, physicians and specialists from more than 100 countries. The conference goal is to increase awareness and collaboration so that the latest developments in lung cancer can be understood and implemented throughout the world. Falling under the theme of “Fighting Lung Cancer,” the conference will cover a wide range of disciplines and unveil several research studies and clinical trial results. For the first time, IASLC has invited survivors to attend the conference free of charge. For more information on the 2015 WCLC, visit: http://wclc2015.iaslc.org/.

About the IASLC:

The International Association for the Study of Lung Cancer (IASLC) is the only global organization specifically dedicated to the study of lung cancer. Founded in 1974, the association's membership includes nearly 4,000 lung cancer specialists in 80 countries. For more information, visit: https://www.iaslc.org/.

 

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September 8, 2015