Prevalence of Non-small Cell Lung Carcinoma among

Smokers and Non-smokers

N. N. Soeroso

, R. Zain-Hamid

, S. P. Tarigan

, S. Bihar

and A. S. Wahyuni

Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara,

Universitas Sumatera Utara Hospital, Jl. Dr. Mansyur No. 66 Medan 20154, Sumatera Utara, Indonesia

Department of Pharmacology and Therapeutics, Faculty of Medicine, Universitas of Sumatera Utara,

Jl. Dr. Mansyur No. 5 Medan 20155, Sumatera Utara, Indonesia

Department of Community Medicine, Faculty of Medicine, Universitas of Sumatera Utara,

Jl. Dr. Mansyur No. 5 Medan 20155, Sumatera Utara, Indonesia

Keywords: Non-small Cell Lung Carcinoma, Lung cancer, Smoker, Non-smokers.

Abstract: Lung cancer is the most found cancer cases in the whole world with an increase of 1.2 million total patients

every year. This has shown a high death rate. This study aims to see the prevalence of non-small-cell lung

carcinoma among smokers and non-smokers. The research design used here is a case-control study with 69

cases and 74 control subjects using purposive sampling. Data is collected from medical record in H. Adam

Malik General Hospital and USU Hospital. Data is analyzed with Epi Info software using logistic regression

test. There is a relationship between age, smoking habit and lung cancer (p<0.001). Patients with a high risk

of lung cancer are active smokers age >60 years. Adenocarcinoma is the most prevalent among carcinoma

type. Patients with adenocarcinoma tend to be non-smoker females age >60 years.

1 INTRODUCTION

Lung cancer is the most common cancer found in the

whole world with an increase of 1.2 million patients

per year (Parkin, 2000). It shows a high death rate

(Globocan, 2012). According to GLOBOCAN

(IARC), in the year 2012, the death rate caused by

lung cancer is 41.1% (Globocan, 2012).

Based on research done by (Jemal, 2010). showed

lung cancer has got a worse prognosis compared to

other types of cancer, and it shows a low survival rate

(Jemal, 2010). In Indonesia, 67.4% males and around

4.5% females consume tobacco, either in the form of

cigars that produce smoke or non-cigars (without

smoke).

Lung cancer occurs after long-term damage to

genetic material in the cell due to prolonged exposure

to risk factors. So far, the most significant risk factor

for lung cancer is tobacco smoking habits which can

be related to ± 85% of lung cancer cases in the United

States that led to death. This research aims to observe

the characteristic of non-small-cell lung carcinoma

among smokers and non-smokers.

2 METHODS

The research design used is case-control with 69 case

and 74 control subjects. Data is collected from

medical history in medical record installation in

H.Adam Malik General Hospital and Universitas

Sumatera Utara Hospital.

The sampling method used is purposive sampling

technique based on male and female lung cancer

patients who have been diagnosed with cytology/

histopathology of adenocarcinoma or squamous cell

carcinoma, age below 40 to over 60 years. Smoking

status is non-smoking (a person who has never

smoked and inhaled cigarette smoke), passive smoker

(a person who inhales cigarette smoke from a smoker)

and active smoker (a person who inhales cigarette

smoke directly). The relationship characteristic was

analyzed using Epi Info software with logistic

regression test. The meaning of statistical test is

determined by p<0.05 and 95% confidence interval

(CI).

Soeroso, N., Zain-Hamid, R., Tarigan, S., Bihar, S. and Wahyuni, A.

Prevalence of Non-small Cell Lung Carcinoma among Smokers and Non-smokers.

DOI: 10.5220/0010081206310634

In Proceedings of the International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches (ICOSTEERR 2018) - Research in Industry 4.0, pages

631-634

ISBN: 978-989-758-449-7

631

3 RESULTS

3.1 Characteristics of Non-small Cell

Lung Carcinoma Patients

Table 1: The Relationship of characteristics between case and control

Logistic Regression test

Table 1 showed that there is a relationship

between age and smoking habit with lung cancer

incidence. Patients with a high risk of lung cancer are

active smokers, age >60 years.

Table 2: The Relationship between subject characteristic and type of carcinoma

Adenocarcinoma Squamous

p-value OR 95% CI

n % n %

Gender Male 28 45,2 6 85,7

0.07

1 1

Female

34 54,8 1 14,3 7.2 0.8-64.1

Age <50 7 11,3 3 42,9

0.073

1 1

51-60 27 43,5 3 42,9 3.85 0.63-23.4

>60 25 40,3 1 14,3 10.7 0.95-119.4

Smoker

Non smoker and

Passive smoker

33 53,2 1 14,3

0.051

1 1

Active smoker 29 46,8 6 85,7 0.14 0.01-1.28

Total 62 100,0 7 100,0

Logistic Regression test

Table 2 showed the patient disposed to have

adenocarcinoma was female, age >60 years and non-

smoker, although statistically was not significant.

Table 3: Type of carcinoma

n %

Adenocarcinoma 62 89,9

Squamous 7 10,1

Table 3 showed the majority of carcinoma’s type was

adenocarcinoma (89,9%)

Case Control

p-value OR 95% CI

n % n %

Gender Male

34 49,3 35 47,3

0.81 1.08 0.56 - 2.08

Female

35 50,7 39 52,7

Age <40

1 1,4 41 55,4

<0.001

1 1

41-50

8 11,6 16 21,6 20.4 2.3-177.1

51-60

30 43,5 8 10,8 153.6 18.2-1294.6

>60

26 37,7 1 1,4 1065.4 63.8-17780.7

Smoker Non Smoker

18 26,1 39 52,7

<0.001

1 1

Passive Smoker

16 23,2 0 0,0 NA NA

Active Smoker

35 50,7 35 47,3 2.16 1.04-4.49

Total

69 100,0 74 100,0

ICOSTEERR 2018 - International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches

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4 DISCUSSION

Based on the distribution frequency of subject

characteristic in this research, the most common age

among the lung cancer patients is >60 years with a

similar number of total male and female. Male

patients are active smokers whereas the female is

non-smokers. This research shows the relationship

between age, smoking habit and lung cancer cases.

This is similar to the research done by (Mong, 2011)

who stated that lung cancer is found the most at the

age of over 60 years (± 51.4%) (Mong, 2011), and

research by (Saragih, 2012) stated that 40.8% of lung

cancer cases found in the age group of over 60,

followed by 51-60 age group (35.3%) (Saragih,

2012). Another research related to lung cancer found

that the incidence increase with age due to the more

extended exposure of risk factors and the declining of

cell-repair capability (Kumar & Anirban, 2004).

There are several risk factors for lung cancers for non-

smokers, especially in females such as exposure to

environmental smoke, occupational, indoor and

outdoor pollution, prion diseases and genetic factors

(Sun, 2007).

From 69 cases of lung cancer cases in this

research, the most found cytology/histopathology is

adenocarcinoma (89.9%) compared to 10.1% of

squamous cell carcinoma. The same finding by

(Soeroso, 2018). suggested that 92.9 % of lung cancer

patients were adenocarcinoma (Soeroso, 2018).

However, this aligns with the study done to the

population in India, in which adenocarcinoma types

are the most found in lung cancer, which is around

30.9% (Malik, 2013).

Another study found that adenocarcinoma is

usually found in a female, influenced by hormonal or

genetic factors. Nicotine metabolism in a female is far

different from that in a male. Moreover, a female has

got high P53 incidence, K-ras mutation and tended to

develop papillomavirus infection (Liu, 2004).

(Syahruddin, 2018) found EGFR mutation exon 19

ins/dels and exon 20 (L858R) respectively 35.6% and

32.8% among Indonesia population (Syahruddin,

2018).

5 CONCLUSIONS

The conclusion from this study is that there is a

relationship between age, smoking habits, and lung

cancer incidence. Patients with the potential to suffer

from lung cancer are active smokers, male ages >60

years. While the adenocarcinoma type tends to

develop in non-smokers, female ages >60 years.

FUNDING

The research is funded by DRPM research institution

program of Ministry of Research, Technology and

Higher Education Indonesia in 2018.

ACKNOWLEDGEMENTS

The researcher would like to thank H. Adam Malik

General Hospital and USU Hospital which have

allowed the retrieval of medical history data.

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