Abstract Rationale The global clinico-pathological profile of lung cancer has evolved, marked by a histologic shift towards adenocarcinoma and a rising prevalence in non-smokers. Indian epidemiological data suggest significant variations from Western patterns. We conducted a retrospective analysis in a new eastern Indian hospital to characterize these unique demographic features, with specific emphasis on smoking status and histopathological trends in the Indian population. Methods We performed a data analysis of thoracic tumors managed in the Department of Pulmonary Medicine and Radiation Oncology between June 2014 and May 2025 to study the demographic and clinic-pathological profiles of lung cancer patients. Data were collected directly from patients’ inpatient and outpatient records. All patients with histologically proven lung cancer were included. Results A total of 2,683 patients were included in the database, of whom patients with other malignancies, benign tumors, and those with significant missing data were excluded. There were 1,883 males and 792 females, with a male-to-female ratio of 2.38. Average age of presentation was 57.76 ± 12.53 (male average age 59.24 ± 12.67and female 53.24 ± 12.42). A total of 75 (44 male and 31 female) are up to 30 years old. Among those histories available, 578/1260 (46%%) patients were non-smokers. Among smokers, Bidi (rolled tobacco in Tendu leaves) smoking and cigarettes are standard modes of smoking; more than 91% patients presented with metastatic primary lung cancer at diagnosis. Among patients with a definitive cyto-histological diagnosis, the prevalence of adenocarcinomas was highest (76.57%) among Non-small Cell Lung Carcinomas, followed by squamous cell carcinomas (18.42%), small cell carcinomas (7.8%), and the remainder were non-small cell carcinomas NOS or other tumors. Among those NSCLC patients who underwent mutation studies, available EGFR-positive mutations were observed in 38% of cases, with a predominant occurrence in exon 19 in 58% and exon 20 in 15% of cases. ALK mutations were seen in 6% of cases. Five patients have concomitant EGFR and ALK mutations. Compound mutations were identified in 2.45% of cases, with 15 individuals having dual mutations and one individual having a triple mutation. Conclusions Most Primary Lung Cancer patients present with metastatic disease, exhibiting significant epidemiological trends towards a predominant adenocarcinoma histology. The demographic profile of patients with lung cancer in eastern India has a higher proportion of never smokers, especially in women. Further studies are required to analyze the plausible etiology of lung cancer in non-smokers, especially among non-smoking women. This abstract is funded by: None
Mohapatra et al. (Fri,) studied this question.