Decade of lung cancer in Serbia: tobacco abuse and gender differences

Lung cancer (LC) is one of the most frequently diagnosed cancers and the leading cause of cancer mortality worldwide. The aim of this study was to get a comprehensive insight into the epidemiology of LC among patients in Vojvodina, the Northern Serbian region, during the ten-year period.

This retrospective study was performed using LC hospital registry data of the Institute for Pulmonary Diseases of Vojvodina (IPBV) from 2011 to 2020. All patients reported in the registry with a place of residence in Vojvodina were included in this study. The data used in this research were: date of diagnosis, gender, age at diagnosis, place of residence, smoking habits at diagnosis, the intensity of smoking (pack/years), ECOG performance (0-5), histological cancer type, TNM classification and disease stage.

A total of 12,055 LC patients were included, 69.6% of whom were male. The percentage of female LC patients significantly increased, from 26.9% in 2011 to 35.9% in 2020 (p<0.001). Non-small cell lung cancer (NSCLC) was diagnosed in 80.8% of patients, while 15.4% of patients had small cell lung cancer (SCLC). The most common histological type was adenocarcinoma (41.9%), followed by squamous cell carcinoma (30.0%) and SCLC (15.4%).

The number of diagnosed LC patients in the Northern Serbian region increased over the past decade and is significantly higher in females. There was a strong correlation between smoking habits and LC in both genders. Our results also indicate the importance of introducing and promoting LC screening programs for all risk populations, particularly current and ex-smokers of younger age.