Evaluation of the Association of Indoor Living Conditions and External Work Environment with Epidemiology, Baseline Demographic and Molecular Characteristics of Lung Cancer in North India

Introduction: Lung cancer has emerged as a global problem with the highest recorded mortalities amongst all types of cancer. There are multiple etiological factors associated with lung cancer such as smoking, environmental pollution, occupational exposure to carcinogens etc. Increase in lung cancer incidence among non-smokers is generally attributed to environmental pollution and occupational exposure. Also, an increase in the percentage of patients with targetable oncogenic drivers has been observed. Methods: Here, we evaluated the effect of domestic conditions on epidemiology, baseline demographic and molecular characterization of lung cancer in India. For this data about domestic conditions such as housing type, kitchen type, fuel type, ventilation conditions and occupation was available from April 2018 to December 2019. Results: Clinicopathological parameters of 1689 newly diagnosed lung cancer patients over the period of 3 years were recorded. Median age was 60.0years and 74.0% patients were smokers. The analysis data set for domestic conditions included 1018 patients. Working environment (indoor versus outdoor environment) had an association with lung cancer histology. 64.5% of lung cancer cases were found in people working in open outdoor environment (construction site workers, labourer, Farmers etc). People working in a closed office environment and housewives had higher frequency of adenocarcinoma and activating EGFR mutation and ALK rearrangement. Conclusion: Domestic conditions and working environment not only selectively impact the lung cancer histology frequency but may also affect the frequency of oncogenic mutations and gene rearrangement.