Lung cancer incidence in Sulaimani province during (2011–2015)

Abstract

Lung cancer is the high frequent form of cancer in the world (12.3% of all cancers). It was estimated to be 1.8 million new cases in 2012 (12.9% of the total), 58% of which occurred in the developing countries (Ferlay et al., 2013 [1]). According to International Agency for Research on Cancer (IARC), lung cancer is one of the most common causes of death worldwide. In recent years incidence of bronchogenic cancer has been growing in different areas of Sulaimani¹ Governorate, which is one of the Kurdistan Regional Government’s governorates located at northern Iraq. The aim of this study was to determine the incidence rate of new lung cancer cases and its distribution in different areas of Sulaimani Governorate (excluding mortality and prevalence data) from 2011 to 2015. Our data source was Hiwa hospital which is the only referral hospital in the governorate. Totally 611 cases of lung cancer were recorded during the period 2011–2015 with 483 male, 128 female cases and also the annual crude rate for all age groups and both sexes was 6.3 per 10⁵ population per year with the annual percentage of 8.5% of all cancers. Our finding was that lung cancer incidence rate increased significantly with increasing in age and the incidence rate of lung cancer increased with time in Sulaimani province.

Objective

The aim of this study was to determine the incidence rate of new lung cancer cases and its distribution in different areas of Sulaimani Governorate (excluding mortality and prevalence data) from 2011 to 2015.

Introduction

Cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells. If the spread is not controlled, it can result in death [2]. Lung cancer is the most common registered cancer worldwide [3]. It is the main cause of cancer death in the world with 18% of cancer deaths (moreover one million deaths per year) [4]. Cancer is caused by external factors, such as tobacco, infectious organisms, and unhealthy diet, and internal factors, such as inherited genetic mutations, hormones, and immune conditions. These factors may act together or in sequence to cause cancer. Ten or more years often pass between exposure to external factors and detectable cancer. Treatments include surgery, radiation, chemotherapy, hormonal therapy, immune therapy, and targeted therapy (drugs that interfere specifically with cancer cell growth) [2]. The lung cancer remains as a predominant cancer in men worldwide, where 1.2 million cases have occurred in men in 2012 (16.7% of the total cancer patients were men) [5]. It is ranked second after breast cancer in Sulaimani likewise is the most common cancer in men.

The most common reason for lung cancer with 80%–90% of cases was linked to cigarette smoking [1], [2]. Toward the end of the 20th century, lung cancer became one of the preventable causes of death. It had been an uncommon disease at the beginning of that century, and at the end of the 20th century exposure to new etiologic agents, increasing lifespan, at the same time tobacco had been broadly utilized all around the globe which contained different types of additives with addictive & carcinogenic properties, all of them contributed to surge in number of bronchogenic cancer patients around the world [3]. Also there are other causes some acting synergistically increase risk. Radon in indoor environments is now considered to be a significant cause of lung cancer [6], [16]. The occupational causes of cancers including lung due to exposure to chromates and uranium mine has been occurred by 1930 [7]. Outdoor air pollution, maybe; combustion-generated carcinogens, seems to participate with the lung cancer burden in urban dwellers. The epidemic of lung cancer began first in man than in women, but, opposite to the situation in men, lung cancer incidence rate in women are still step-up due to rising in the number of women smokers [3].

As many of lung cancer risk factors are preventable (especially cigarette smoking) the way for reduction and prevention of lung cancer is by legalisation and putting strong strategies toward the decreasing of smoking (especially preventing youths from starting smoking) that lowers the risk factors and decreases lung cancer incidence in populations of the globe [8], [21].

Sulaimani province as other Iraqi provinces has faced several wars and use of different weapons including chemical weapons that polluted the environment otherwise after Iraqi regime have been destroyed in 2003, changes in lifestyle, industrialization and urbanization occurred and increased mostly without protective legalisation which increased exposure to environmental carcinogens [9], [10]. Also the Regional Governments economy depends mostly on oil industry which have a negative effect on environment that made professionals to warn government to take steps toward reducing environmental pollution that have a great trend over the increasing of cancer incidence in the region in recent years. Our study is important as there is few published article about the cancer incidence in Sulaimani.