Lung Cancer

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WHO-ICD-10 version:2010

Neoplasms

Malignant neoplasms

OMIM Number

211980

Mode of Inheritance

Autosomal recessive

Gene Map Locus

1q24.3 ,2q33.1,3q26.3,5q31.1 ,6q26,7p11.2, 7q34,10p11.23,11p15.54, 11q23.1,12p12.1,17q12,19q13.2

Description

Most primary lung cancers are carcinomas of the lung, originating from epithelial cells. Non-small cell lung carcinoma (NSCLC) accounts for approximately 75% of all lung cancers, making it more common than small cell lung carcinoma. NSCLC is subdivided further into three main sub-types: squamous cell lung carcinoma, adenocarcinoma and large cell lung carcinoma. Recently, adenocarcinoma has been noted as the most common histological subtype. This subtype is observed most commonly in non-smokers. Moreover, the bronchioloalveolar carcinoma, a subtype of adenocarcinoma, is more common in female non-smokers. Squamous cell lung carcinoma accounts for 25-30% of all lung cancers, whereas large cell lung carcinoma is the least common of all NSCLCs which accounts for 10-15% of lung cancers. Unlike many other malignancies, whose causes are largely unknown, the cause of lung cancer is tobacco smoking in as many as 90% of patients. Other environmental factors like asbestos, radon gas and air pollution, including second-hand smoke also contribute to lung cancer. In addition, recent evidence suggests that viruses may cause lung cancer including human papilloma virus, JC virus, simian virus 40 (SV40), BK virus, and cytomegalovirus. Lung cancer is the most common cancer in the world, and it is responsible for 1.3 million deaths worldwide annually. However, it is more common in men than women.

Mutations in several genes can be involved in the pathogenesis of lung cancer. However, the major susceptibility loci are mapped to 6q23-q25 (LNCR1), 15q25.1 (LNCR2), 5p15 (LNCR3), 6p21 (LNCR4), and 3q28 (LNCR5). K-ras proto-oncogene mutations are responsible for 20-30% of non-small cell lung cancers. Somatic mutations in the BRAF, ERBB2, MET, STK11, PIK3CA, and PARK2 genes have also been identified in lung cancer patients. In addition, several polymorphisms are associated with lung cancer in genes coding for interleukin-1, cytochrome P450, XRCC1 gene, and ERCC6 gene.

Epidemiology in the Arab World

View Map
Subject IDCountrySexFamily HistoryParental ConsanguinityHPO TermsVariantZygosityMode of InheritanceReferenceRemarks
211980.1LebanonUnknown Lung adenocarcinomaNM_005228.5:c.2573T>GFakhruddin et al, 2014 Only one case of EGF...
211980.2LebanonUnknown Lung adenocarcinomaNM_033360.4:c.34G>AFakhruddin et al, 2014 One patient from a s...
211980.3LebanonFemale Non-small cell lung carcinomaNM_004333.6:c.1798delinsTACAEl Karak et al, 2015 BRAF mutation observ...
211980.4LebanonUnknown Lung adenocarcinomaNM_005228.5:c.2369C>TNaderi et al, 2015 EGFR mutation observ...
211980.G.1ArabUnknown Lung adenocarcinomaNM_005228.5:c.2573T>GHeterozygousAutosomal, DominantTfayli et al. 2017 From a study of 210 ...
211980.G.2.1LebanonUnknown Neoplasm of the lungNG_011740.2:g.3470_3471=Fakhoury et al, 2012a Study with 41 lung c...
211980.G.3.1LebanonUnknown Neoplasm of the lung;NG_012100.1:g.3391_3395=Fakhoury et al, 2012b Study with 41 lung c...
211980.G.4.1LebanonUnknown Lung adenocarcinomaNM_033360.4:c.34G>TFakhruddin et al, 2014 19 patients from a s...
211980.G.4.2LebanonUnknown Lung adenocarcinomaNM_033360.4:c.35G>CFakhruddin et al, 2014 11 patients from a s...
211980.G.4.3LebanonUnknown Lung adenocarcinomaNM_033360.4:c.35G>AFakhruddin et al, 2014 Five patients from a...
211980.G.4.4LebanonUnknown Lung adenocarcinomaNM_033360.4:c.35G>TFakhruddin et al, 2014 Two patients from a ...
211980.G.4.5LebanonUnknown Lung adenocarcinomaNM_033360.4:c.37G>TFakhruddin et al, 2014 Two patients from a ...
211980.G.4.6LebanonUnknown Lung adenocarcinomaNM_033360.4:c.38G>AFakhruddin et al, 2014 Two patients from a ...
211980.G.5Arab Lung adenocarcinomaNM_005228.5:c.2573T>GTfayli et al. 2017 7 individuals out of...

Other Reports

Bahrain

Al-Hamdan et al. (2006) studied lung cancer incidences among GCC (Gulf Cooperation Council) nationals based on the data extracted from National Cancer Registries (NCRs) of each GCC country. Of the total of 1607 cases (1261 males and 346 females) of primary lung cancer registered between 1998 and 2001, there were 204 Bahrainis (151 male and 53 females; male:female ratio- 2.8:1). Lung cancer was also found to be the most common cancer among males in Bahrain. In both males and females, the Bahraini group showed the highest Age Standardized incidence Rate (ASR) for lung cancer at 34.3 and 12.1, respectively. In addition, both Bahraini males and females showed the highest mean age at diagnosis (68.7 and 68.2 years, respectively). Histologically, the predominant type of carcinoma was found to be squamous cell carcinoma in males and adenocarcinoma in females. The prevalence of smoking among the affected Bahraini group was found to be 25.8% in males and 8.8% in females. Interestingly, the rate in females was at least six times higher that those in other GCC countries. About 84% of male and 65% of female Bahraini cases were found associated with smoking. Al-Hamdan et al. (2006) indicated that the Bahraini estimates precisely reflected the world pattern, and surmised that the higher prevalence and longer history of smoking was reflected in the higher incidence of lung cancer among the Bahraini nationals. Al-Hamdan et al. (2006) advised that smoking cessation was the best way to reduce the risk of lung cancer.

Applying the same criteria as the previous authors on all histopathology and hematopathology archives from all government and private hospitals across Bahrain, Alhilli et al. (2007) found only 54 Bahraini patients (47 males and seven females) with lung cancer between 1998 and 2001, as supposed to 204 patients in the same period in the earlier study. Primary lung cancer was still the second most common cancer among Bahraini males in the study of Alhilli et al. (2007).

Later, Al-Hamdan et al. (2009) undertook a study to calculate the age-standardized incidence rate (ASR) per 100,000 person-years among lung cancer patients in the Gulf Cooperation Council countries (GCC) by the direct standardization method using all the primary lung cancer cases registered in the Gulf Center for Cancer Registration during 1998 to 2001. Al-Hamdan et al. (2009) found that 1607 (1261 males, 346 females) primary lung cancer cases were registered during this period in all the GCC countries with the male to female ratio of 3.6:1. Al-Hamdan et al. (2009) found that Bahrain had the highest age-standardized incidence rate (ASR) among the GCC countries which accounts 34.3 and 12.1 for males and females, respectively. The mean age at diagnosis was 68.7 and 68.2 years for males and female, respectively. They also found that squamous cell carcinoma was the predominant histological type in males in all the GCC countries except Qatar. While adenocarcinoma was the predominant histological type in females among the GCC countries. Al-Hamdan et al. (2009) concluded that cancer of the lung is one of the common cancers among males in all the GCC countries and ranks second among Bahraini females.

Egypt

[See: Lebanon > Tfayli et al. (2017)]

Iraq

[See: Lebanon > Tfayli et al. (2017)]

Jordan

El-Akawi et al. (2006) studied Alpha-1 Antitrypsin genotypes in paraffin embedded tissue blocks from 100 patients (86 males, 14 females) with lung carcinoma.  This included 83 patients with non-small and 17 patients with small-cell lung carcinoma.  PCR-RFLP analysis showed that all 100 tested samples from these patients were homozygous for the M allele, while no Z or S alleles were detected.

Mahasneh et al. (2012) conducted a study in 49 (5 women and 44 men) lung cancer patients, 54 (26 women and 28 men) colorectal cancer patients and 99 (7 women and 92 men) cancer-free controls.  Using PCR-RFLP, the polymorphisms of NAT2 gene were screened.  Five types of the alleles were found, the wild type WT (NAT2*4) allele and the M1 (NAT2*5A), M2 (NAT2*6A), M3 (NAT2*7), and the M4 (NAT2*14A) polymorphisms caused by point mutations in the NAT2 gene.  The M2 polymorphism was apparent in the lung and colorectal cancer patients.

[See also: Lebanon > Tfayli et al. (2017)]

Kuwait

Aboul et al. (1997) evaluated 74 cases of lung cancer admitted to the Kuwait Chest Diseases Hospital between 1991 and 1996 (63 males, 11 females; age range: 25 to 80 years). Only 27 of these patients were Kuwaitis. Majority of the cases (57%) were smokers. Non-small cell lung cancer was diagnosed in 62 cases, while the rest had small cell lung cancer. Most patients presented in advanced stages; 32 at stage IV, 13 at stage III, 11 at stage II, and only six at stage I. The major type of cancer was squamous cell carcinoma (36 patients), while the least common type was large call carcinoma (two cases). [Aboul AT. Evaluation of lung cancer cases admitted to Kuwait Chest Diseases Hospital from June 1991 to June 1996. Al-Azhar Med J. 1997; 26(3-4):291-302.]

In a study by Al-Hamdan et al. (2006) to determine and compare lung cancer rates in GCC countries between 1998 and 2001, 128 Kuwaiti nationals (96 males and 32 females; male:female ratio- 3:1) were found registered in the NCR. Lung cancer was found to be the second most common cancer among Kuwaiti males. The age standardized incidence rate (ASR) among Kuwaiti males and females was found to be 13.8 and 4.0, respectively. Interestingly, the Kuwaiti registrants showed the highest smoking prevalence (32.4%). [See also: Bahrain > Al-Hamdan et al., 2006]

Al-Hamdan et al. (2007) calculated the age-standardized incidence rate (ASR) per 100,000 person-years among lung cancer patients in Kuwait. ASR was 13.8 and 4.0 for male and female, respectively. [See also: Bahrain > Al-Hamdan et al., 2007]

Al-Sarraf et al. (2008) tried to assess the clinical and prognostic significance of maximum standardized uptake value (SUV-max) by integrated PET-SC of 176 patients with non-small cell lung cancer. The findings showed that SUV-max correlated with tumor characteristics, surgical stage, and prognosis following resection.

Lebanon

Tfayli et al. (2017) studied 205 lung adenocarcinoma patients. These included 135 Lebanese, 14 Syrians, 4 Palestinians, 24 Jordanians, 32 Iraqis and an Egyptian. 25 patients tested positive for exon 19 deletions in the EGFR gene, while 3 patients were found to have the EML4-ALK translocation  

Oman

In a study by Al-Hamdan et al. (2006) to determine and compare lung cancer rates in GCC countries between 1998 and 2001, 195 Omani nationals (159 males and 36 females) were found registered in the NCR. The male to female ratio was highest among the Omani cases (4.4). Lung cancer was found to be the third most common cancer among Omani males, while the age standardized incidence rate (ASR) among Omani males and females was found to be 8.4 and 2.2, respectively. The Omani male registrants showed the lowest smoking prevalence (15.5%). Later, Al-Hamdan et al. (2007) calculated the mean age at diagnosis among lung cancer patients in Oman as 59.2 and 58.0 years for males and females, respectively.

[See also: Bahrain > Al-Hamdan et al., 2006; Al-Hamdan et al., 2007]

Palestine

[See: Lebanon > Tfayli et al. (2017)]

Qatar

Al-Hamdan et al. (2006) conducted a study to determine and compare lung cancer rates in GCC countries between 1998 and 2001. A total of 36 Qatari nationals (29 males and 7 females; male:female ratio-4.1:1) were registered in the NCR. Lung cancer was found to be the most common cancer among Qatari males, while the age standardized incidence rate (ASR) among Qatari males and females was found to be 9.9 and 2.3, respectively. Smoking prevalence was fairly high among the Qatari male registrants (23.6%). Later, Al-Hamdan et al. (2007) calculated the age-standardized incidence rate (ASR) per 100,000 person-years among lung cancer patients in Qatar as 18.5 and 5.5 for males and females, respectively.

Bener et al. (2008) retrospectively studied the Qatar National Cancer Registry to assess the trend in various cancer incidences in Qatar. Lung cancer was diagnosed in 33 Qatari patients between 1991 and 1996, 43 Qataris between 1997 and 2001, and in 38 Qataris between 2002 and 2006.

[See also: Bahrain > Al-Hamdan et al., 2006; Al-Hamdan et al., 2007]

Saudi Arabia

In a study by Al-Hamdan et al. (2006) to determine and compare lung cancer rates in GCC countries between 1998 and 2001, 979 Saudi nationals (778 males and 201 females; male:female ratio-3.9:1) were registered in the NCR. Lung cancer was found to be the fourth most common cancer among Saudi males, while the age standardized incidence rate (ASR) among Saudi males and females was found to be 4.8 and 1.3, respectively. Smoking prevalence among the Saudi male registrants was 20.3%. Later, Al-Hamdan et al. (2007) calculated the age-standardized incidence rate (ASR) per 100,000 person-years among lung cancer patients in Saudi Arabia as 4.8 and 1.3 for males and females, respectively. This rate is considered as the lowest compared to other GCC countries.

[See also: Bahrain > Al-Hamdan et al., 2006; Al-Hamdan et al., 2007]

Syria

[See: Lebanon > Tfayli et al. (2017)]

United Arab Emirates

Al-Hamdan et al. (2006) conducted a study to determine and compare lung cancer rates in GCC countries between 1998 and 2001. A total of 65 Emiratis (48 males and 17 females; male:female ratio-2.8:1) were registered in the NCR. Lung cancer was found to be the most common cancer among Emirati males, while the age standardized incidence rate (ASR) among Emirati males and females was found to be 7.2 and 2.9, respectively. Smoking prevalence was fairly high among the Emirati male registrants (20.9%). Al-Hamdan et al. (2006) advised that smoking cessation was the best way to reduce the risk of lung cancer.

[See also Bahrain > Al-Hamdan et al., 2006]

Radwan et al. 2018 reviewed 4 retrospective studies with data collected between 1982 and 2004. "The overall age-standardized cancer rates were 70.1 and 74.2 per 100,000 in males and females, respectively. Lung, gastric, and prostate cancer ranked as the top 3 types in Emirati males; while breast, cervical, and thyroid cancer were the top 3 types in Emirati females." 

 

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