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Objectives: Lung cancer patients commonly experience multiple symptoms, both lung-specific and systemic for many months before presentation, irrespective of their disease stage at diagnosis. In this study we aimed to investigate the symptoms and other clinical and sociodemographic factors associated with lung cancer stage at diagnosis.
Methods: Newly diagnosed lung cancer patients admitted to nuclear medicine clinic for PET/CT scanning were included. Their demographic characteristics, symptoms were and their histopathologic results were obtained from the PET/CT data records retrospectively. Staging was made according to TNM8 by PET/CT findings.
Results: Totally 120 newly diagnosed lung cancer patients were evaluated retrospectively. Mean age of them was 66.8±10.6 with male dominance (85.8%). Smoking consumption rate was 86.8% and mean 64.5±40.9 pack years. Most common symptoms were cough (29.1%), chest/back pain (25.8%), dyspnea (21.6%) and hemoptysis (12.5%). Histopathological subtypes were adenocarcinoma (42.5%), squamous cell carcinoma (SCC) (27.5%), non-small cell lung cancer (15.8%), small cell lung cancer (14.2%). According to TNM 8 staging system 51.6% of them had advanced, 38.4% of them had locally advanced and 10% had early stage lung cancer. Most of them had T3-T4 tumors (80.8%) and N2-N3 (83.3%) lymph nodes with increased FDG uptake. The rate of patients with M1a was 8.3% and the rate of patients with distant metastasis was 43.3%. Among all symptoms only hemoptysis had the highest rate in early stage (33.3%), compare to locally advanced (19.6%) and advanced (3.2%) stage patients (p<0.005). Also hemoptysis had highest rate in patients with SCC and non-small cell histology (p<0.05). None of the other demographical or clinical characteristics differed according to the stage of the disease.
Conclusion: According to our results hemoptysis was the strongest symptom to predict early-stages of lung cancer, but occurs in only 14.2% of all patients. For detecting the disease in early stages it is important to make programs also focusing and alarming on the other more common seen symptoms.