Clinico-radiological and Pathological Characteristics of Lung Cancer and its Correlation with their Occupational Profile among Patients of� Employees State Insurance (ESI) Hospital� A Tertiary Care Center in North India

ABSTRACT

Introduction: Occupational exposure is an important risk factor for lung cancer in never smokers contributing to 10�% of lung cancers. We conducted this study to evaluate the clinico-radiological and pathological profile of occupational lung cancer among patients of Employees State Insurance (ESI) Hospital, a tertiary care center. Materials and methods: This was a cross-sectional observational study conducted over 6 years on patients diagnosed with lung malignancy at ESI Hospital and Postgraduate Institute of Medical Sciences and Research (PGIMSR), Basai Darapur, New Delhi. The details regarding their clinical history including onset and progress of the disease were interviewed. Also, the details of whole life, past, and present occupational history in a chronological order were recorded for all subjects. Results: Our study included 171 patients with mean age of 58.34 � 11.52 years and 137 (80%) men. About 80.7% of the patients had a smoking history. The most common histological type was adenocarcinoma seen in 35.09%, followed by squamous cell carcinoma (SCC) in 23.39% of patients. About 70.19% (120/171) patients had occupational exposure. The most common exposure was of polycyclic aromatic hydrocarbons (PAH) seen in 24.8% cases. Others being silica, diesel fumes, organic dust, metal fumes, etc. Fourteen patients had occupational exposure alone in the absence of smoking. Those with pure occupational exposure in the absence of smoking had a significantly lower mean age compared to the nonexposed group (52.21 � 11.92 vs 58.65 � 13.93, p-value = 0.017). SCC was significantly more common in the exposed group compared to the nonexposed (37/120 vs 3/51, p-value = 0.0004). Conclusion: Occupational exposure was found in 70.19% of patients with lung cancer. The occupational lung cancer manifests at an early age and is more commonly associated with squamous cell lung cancer compared to nonoccupation-related cancer