Demographical differentials of lung cancer survival in Bangladeshi patients.
Authors: Islam Muhammad Rafiqul , Hasan ATM Kamrul , Begum Ferdous ara , Khatun Nazrina , Islam Md. Rafiqul , Zaman Asaduz , Arjuman Farida , Ridi Ishrat Nur 
Published: June 2021

10570 Background: Lung Cancer is the leading cause of cancer-related mortality and most common cancer in worldwide with more than a million deaths annually. 20.8% cancer related death caused by lung cancer and more than half of lung cancer occurred in Asia. Differences In the epidemiology of lung cancer among the developing country may shed light on possible genetic and demographical influences on lung cancer survival. Demographic stratification of lung cancer patients of Bangladesh is remain unclear due of lack of data We tried to figure out the demographic pattern and its impact on survival in Bangladeshi lung cancer patient. Methods: Previously diagnosed primary lung cancer patients attending Medical Oncology department of National Institute of cancer research and Hospital, a tertiary care center of Bangladesh, between 2018 and 2019 were included. Demographic and clinical data were collected retrospectively from the medical records. Results: A total of 1868 consecutive patient (1580 males, 288females) diagnosed to have lung cancer; Mean age was 60 years which quite early compare to other countries. Older than 70-year age groups had worse survival outcome (hazard ratio 1.04: 95% confidence interval: 1.17–1.68). Below 50-year group had better outcome with standard adjuvant or palliative chemotherapy whereas older groups had better survival with sequential radiotherapy and chemotherapy or concurrent chemo radiation (Hazard Ratio 0.45; 95% confidence interval: 0.30–0.67). Sex was not a predicting factor for overall survival (Hazard ratios 1.04 95% confidence interval 0.89- 1.22, P = 0.621). But, Male had better treatment response than the female (Hazard ratio and 95% confidence interval: 0.51 and 0.42-0.61, P = < 0.001). Education level had significant impact on survival outcome (Hazard ratio 0.58 and 95% confidence interval: 0.47-0.71, P = < 0.001). Underweight group had worse survival than the normal BMI group (Hazard ratio1.18 and 95% confidence interval 1.05-1.31, P = 0.005). Having the Comorbid condition at the time of diagnosis had shorter survival (Hazard ratio 1.16 and 95% confidence interval 1.04-1.30 P = 0.007). Histological variation had no survival benefit among the squamous, small cell or other histological types (p = 0.214, 0.494, 0.658 respectively). But adenocarcinoma or small cell carcinoma had better treatment response outcome. Eastern Cooperative Oncology Group performance status (ECOG-PS) 4 had worse outcome (Hazard ratio 1.95, 95% confidence interval 1.37–2.79; P = < 0.001). Conclusions: The socio-demographic related survival in lung cancer needs to be fully elucidated because of its implication in the design of experimental protocols for targeted chemoprevention, early disease screening, molecular marker based staging, and individualized treatment. Due to its extraordinary disease burden and the international variability in demographic variables, the lung cancer requires continual monitoring.