Smoking and lung cancer: Data from a single center in Greece

Introduction: Greece is a country with a high prevalence of smoking but a national cancer registry has only recently been initiated and data on lung cancer are scarce. Aim - Methods: In 2012-2013, 287 patients presented to our dept with either symptoms or an abnormal finding in their chest X-ray and were diagnosed with lung cancer. This is a descriptive study, reporting data on the histological type of cancer, staging and smoking history. Results: Of the 287 patients, 246 were men (mean age 65.1, range 30-84years and 41 women (42.2, 45-82). Only 16 patients were non-smokers, 59 were ex-smokers and the remaining were current smokers with high exposure (mean history of 80pack/years). Diagnosis was confirmed histologically in 172 and by cytology only in 115 patients. SCLC was confirmed in 96 patients (33.3%), adenocarcinoma in 74 (25, 7%), squamous cell carcinoma in 64 (22.7%) and NOS NSCLC in 40 (14%). Moreover, 4 patients had large cell carcinoma and 9 mesothelioma. Regarding NSCLC, 53% of patients were stage IV at diagnosis, 14% IIIB and 13% IIIA. 87% of those patients received first line chemotherapy, mostly with platinum–based doublets, while only 5% of adenocarcinomas showed EGFR mutations associated with TKI response and received targeted treatment. 30% of these patients also received second line chemotherapy. The remaining 39 patients were stage I or II at diagnosis. 15 were not eligible for surgery and only 24 underwent surgery. Conclusion: It seems that in Greece there is a high prevalence of SCLC, probably associated with the heavy history of smoking and most patients are diagnosed at a late stage. Policies for smoking cessation should be strengthened and a lung cancer screening program should be initiated.