Characteristics, risk factors and histopathological types of bronchogenic carcinoma among cases presented to Chest Department, Al-Zahraa Hospital, Al-Azhar University

Omaima I. Abo-Elkheir, Manal R. Hafez


Background: Recently, lung cancer representing 5-7% of all cancers in Egypt with unavailable accurate epidemiological data. This study aims to identify characteristics, risk factors and histopathological types of bronchogenic carcinoma among a group of Egyptian patients.

Methods: A cross sectional study was conducted on 123 cases of histopathological confirmed bronchogenic carcinoma presented to chest diseases department, Al-Zahraa Hospital, Al-Azhar University, Egypt in the period from July 2013 to May 2017. Statistical analysis of patients’ database was done using SPSS version 17.

Results: Male to female ratio was 3.2:1; the majority of cases presented in their fifth (55.3%) and sixth (29.3%) decades of life, and urban: rural residence ratio was 2.1:1. Smoking was the most significant risk factor among 93.5% of cases, among them 65.9% were current smokers, 13.0% were ex-smokers and 14.6% were passive smokers. Occupational exposure to cement dust were reported among 47.2% of cases, 16.3% were farmers, 13.0% were employees, 8.9% were house wives, 8.1% were shoe makers and 6.5% were drivers. COPD was reported among 54.5% of cases. The commonest histopathological types were squamous cell carcinoma (31.7%), adenocarcinoma (30.9%), and large cell carcinoma (26.0%). Adenocarcinoma was the predominant type among females (55.3%), passive smokers (31.6%) and non-smokers (15.8%).

Conclusions: Small cell lung cancer and squamous cell carcinoma subtypes were predominant among males, active smokers and workers exposed to cement dust. Adenocarcinoma was the commonest type among females, passive smokers and non-smokers. Conduction of anti-smoking campaigns; reduction of environmental pollution with regulation of occupational exposures to cement dust are recommended.


Bronchogenic carcinoma, Histopathological type, Risk factors, Egypt

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Dubey AK, Gupta U, Jain S. Epidemiology of lung cancer and approaches for its prediction: a systematic review and analysis. Chinese J Cancer. 2016;35(1):71.

Gupta V, Bhardwaj S, Bhagat OK. Pattern of transbroncial lung biopsy-proven lung malignancies in tertiary care hospital in north India: a clinicopathological study. Int J Adv Med. 2016;3(4):804-7.

Matikas A, Mistriotis D, Georgoulias V, Kotsakis A. Targeting KRAS mutated non-small cell lung cancer: a history of failures and a future of hope for a diverse entity. Crit Rev Oncol Hematol. 2017;110:1–12.

King BA, Mirza SA, Babb SD. For the GATS Collaborating Group. A cross-country comparison of secondhand smoke exposure among adults: findings from the Global Adult Tobacco Survey (GATS). Tob Control. 2013;22:5.

Akl YM, Emam RH, Sabry IM, Ali AA. Clinico-pathological profile of bronchogenic carcinoma cases presented to Chest Department, Cairo University in the last 10 years. Egyptian J Chest Diseases Tuberculosis. 2013;62:705–12.

Field RW, Withers BL. Occupational and Environmental Causes of Lung Cancer. Clinics in Chest Med. 2012;33(4):10.1016.

Masngut MI, Baharudin MR, Rahman AA. A Systematic Review On Risk Factor For Reduce Lung Function Due To Occupational Respirable Dust Exposure 2005-2015. Int J Public Health Clin Sci. 2015;2(4):44-62.

Manjula R, Praveena R, Clevin RR, Ghattargi CH, Dorle AS, Lalitha DH. Effects of occupational dust exposure on the health status of Portland cement factory workers. Int J Med Publ Health. 2013;3(3):192-6.

Gizaw Z, Yifred B, Tadesse T. Chronic respiratory symptoms and associated factors among cement factory workers in Dejen town, Amhara regional state, Ethiopia, 2015. Multidisciplinary Respiratory Med. 2016;11:13.

Institute for Health Metrics and Evaluation. Human Development Network. The World Bank. The Global Burden of Disease: Generating Evidence, Guiding Policy- Sub-Saharan Africa Regional Edition. Seattle, WA: IHME; 2013.

Durham AL, Adcock IM. The relationship between COPD and lung cancer. Lung Cancer (Amsterdam, Netherlands). 2015;90(2):121-7.

Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359–E386.

Urman A, Josyula S, Rosenberg A, Lounsbury D, Rohan T, Hosgood H. Burden of Lung Cancer and Associated Risk Factors in Africa by Region. J Pulm Respir Med. 2016;6:340.

Curado MP, Edwards B, Shin HR, Storm H, Ferlay J, Heanue M, et al. Cancer incidence in five continents, Lyon: IARC; 2007.

Ibrahim AS, Khaled HM, Mikhail NN, Baraka H, Kamel H. Cancer incidence in Egypt: results of the national population-based cancer registry program. J Cancer Epidemiol. 2014;2014:437971.

Masters N. Waterpipe tobacco smoking and cigarette equivalence. Br J Gen Pract. 2012;62(596):127.

Torre LA, Siegel RL, Ward EM, Jemal A. Global Cancer Incidence and Mortality Rates and Trends--An Update. Cancer Epidemiol Biomarkers Prev. 2016;25(1):16-27.

Gupta R, Chowdhary I, Singh P. Clinical, Radiological and Histological profile of Primary Lung Carcinomas. JK Science. 2015;17(3):146-51.

Hathila N, Goswami D. Radiological evaluation of various types of primary bronchogenic carcinoma: a study of 65 cases. Int J Med Sci Public Health. 2016;5(5).

Rawat J, Sindhwani G, Gaur D, Dua R, Saini S. Clinico-pathological profile of lung cancer in Uttarakhand. Lung India. 2009;26:74-6.

Santos-Martínez MJ, Curull V, Blanco ML, Macià F, Mojal S, Vila J, et al. Lung cancer at a university hospital: epidemiological and histological characteristics of a recent and a historical series. Arch Bronconeumol. 2005;41(6):307-12.

Alamoudi OS. Lung cancer at a University Hospital in Saudi Arabia: A four-year prospective study of clinical, pathological, radiological, bronchoscopic, and biochemical parameters. Ann Thorac Med. 2010;5(1):30–6.

Sen E, Kaya A, Erol S, Savas I, Gonullu U. Lung cancer in women: clinical features and factors related to survival. Tuberk Toraks. 2008;56(3):266-74.

Akl EA, Gaddam S, Gunukula SK, Honeine R, Jaoude PA, Irani J. The effects of water pipe tobacco smoking on health outcomes: a systematic review Int J Epidemiol. 2010;39:834-57.

Koul PA, Hajni MR, Sheikh MA, Koul PA, Hajni MR, Sheikh MA, et al. Hookah smoking and lung cancer in the Kashmir valley of the Indian subcontinent Asian Pac J Cancer Prev. 2011;12:519-24.

Becquemin MH, Bertholon JF, Attoui M, Roy F, Roy M, Dautzenberg B. Particle size in water pipe smoke. Rev Mal Respir. 2008;25(7):839-46.

Becquemin MH, Bertholon JF, Attoui M, Roy F, Roy M, Dautzenberg B. Particle size in the smoke produced by six different types of cigarette]. Rev Mal Respir. 2007;24(7):845-52.

Behera D, Balamugesh T. Lung cancer in India. Indian J Chest Dis Allied Sci. 2004;46:269-81.

Hegmann KT, Fraser AM, Keaney RP, Moser SE, Ni`lasena DS, Sedlars M, et al. The effect of age at smoking initiation on lung cancer risk. Epidemiology. 1993;4(5):444-8.

Kakooei H, Gholami A, Ghasemkhani M, Hosseini M, Panahi D, Pouryaghoub G. Dust exposure and respiratory health effects in cement production. Acta Medica Iranica. 2012;50(2):122–6.

Fell AKM, Sikkeland LIB, Svendsen MV, Kongerud J. Airway inflammation in cement production workers. Occupational Environ Med. 2010;67(6):395–400.

Prado GF, Zanetta DMT, Arbex MA, Braga AL, Pereira L AA, de Marchi MRR, et al. Burnt sugarcane harvesting: Particulate matter exposure and the effects on lung function, oxidative stress, and urinary 1-hydroxypyrene. Science of the Total Environment. 2012;437:200–8.

Koh DH, Kim TW, Jang SH, Ryu HW. Cancer Mortality and Incidence in Cement Industry Workers in Korea. Safety and Health at Work. 2011;2(3):243-9.

Egypt: Construction workers: millions suffer marginalization and poverty, 2017. Available at: Accessed on 26 November 2017.

Rachiotis G, Drivas S, Kostikas K, Makropoulos V, Hadjichristodoulou C. Respiratory tract mortality in cement workers: a proportionate mortality study. BMC Pulmonary Med. 2012;12:30.

Mabuchi K, Lilienfeld AM, Snell LM. Cancer and occupational exposure to arsenic: a study of pesticide workers. Prev Med. 1980;9:51–77.

Guha P, Sahai SS, Sarkar D, SardaPr, Singh A, Mandal B, Das BK, et al. Bronchogenic Carcinoma in a Scleroderma Patient with Multiple Metastases: One Case Report. Clin Oncol Cancer Res. 2010;7:214-6.

Lee T, Park JY, Lee HY, Cho YJ, Yoon HI, Lee JH, Jheon et al. Lung cancer in patients with idiopathic pulmonary fibrosis: clinical characteristics and impact on survival. Respir Med. 2014;108:1549–55.

Gao Y, Goldstein AM, Consonni D, Pesatori AC, Wacholder S, Tucker MA, et al. Family history of cancer and non-malignant lung diseases as risk factors for lung cancer. Int J Cancer. 2009;125(1):146–52.

Travis W, Brambilla E, Noguchi M, Nicholson AG, Geisinger KR, Yatabe Y, et al. International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol. 2011;6(2):244–85.