Risk Factors for Lung Cancer in the Pakistani Population


Background: Lung cancer is one of the most prevalent malignancies in the world and both incidence andmortality rates are continuing to rise in Pakistan. However, epidemiological studies to identify common lungcancer determinants in the Pakistani population have been limited. Materials and
Methods: In this retrospectivecase-control study, 400 cases and 800 controls were enrolled from different hospitals of all provinces ofPakistan. Information about socio-demographic, occupational, lifestyle and dietary variables was extractedby questionnaire from all subjects. Odd ratios (ORs) and 95% confidence intervals (CIs) were calculated. anddose-response associations were also assessed for suitable factors.
Results: Strong associations were observed forsmoking (OR=9.4, 95%CI=6.9-12.8), pesticide exposure (OR=5.1, 95%CI=3.1-8.3), exposure to diesel exhaust(OR=3.1, 95%CI=2.1-4.5), red meat consumption (OR=2.9, 95%CI=1.8-4.7) and chicken consumption (OR=2.8,95%CI=1.7-49). Other associated factors observed were welding fumes (OR=2.5, 95%CI=1.0-6.5), sedentaryliving (OR=2.0, 95%CI=1.6-2.6), family history (OR=2.0, 95%CI=0.8-4.9), wood dust (OR=1.9, 95%CI=1.2-3.1), tea consumption (OR=1.8, 95%CI=1.2-2.6), coffee consumption (OR=1.8, 95%CI=1.1-2.8), alcoholism(OR=1.7, 95%CI=1.1-2.5) and asbestos exposure(OR=1.5, 95%CI=0.5-4.4). Consumption of vegetables (OR=0.3,95%CI=0.2-0.4), juices (OR=0.3, 95%CI=0.3-0.4), fruits (OR=0.7, 95%CI=0.5-0.9) and milk (OR=0.6, 95%CI=0.5-0.8) showed reduction in risk of lung cancer. Strongest dose-response relationships were observed for smoking(Χ2=333.8, p≤0.0000001), pesticide exposure (Χ2=50.9, p≤0.0000001) and exposure to diesel exhaust (Χ2=51.8,p≤0.0000001).
Conclusions: Smoking, pesticide exposure, diesel exhaust and meat consumption are main lungcancer determinants in Pakistan. Consuming vegetables, fruits, milk and juices can reduce the risk of lung cancerrisk, as in other countries.