Female lung cancer in Marrakech

Abstract

Background: To evaluate the epidemiological aspect of lung cancer in women in Marrakech city in Morocco. Methods: This is a retrospective study conducted between 2003 and 2009 in the Department of Oncology-Radiotherapy, University Hospital Mohamed VI Marrakech. Results: Twenty nine women with lung cancer were unrolled (9% of all lung cancer). The average age was 55.7 ± 12 years. Only twenty percent of our patients were smokers while 38% reported a greater or lesser exposure to passive smoking. Ninety percent of patients were housewives and 62% were from rural areas and all reported massive exposure to smoke from cooking fuels which was mainly charcoal. Squamous cell carcinoma represents 67% of cases. Tumors were diagnosed at advanced stages II/IV in 81% of cases. Eight patients received neo-adjuvant chemotherapy followed by radio-chemotherapy combination and palliative chemotherapy has been indicated in twelve patients. Nine patients received best supportive care. Average follow-up was of twelve months. Fourteen patients were lost to follow-up. Among fifteen evaluable patients, response was noted in seven patients, stabilization in four patients and progression in four patients. Conclusion: Female lung cancer is a relatively rare condition in Marrakech, Morocco. Although the role of smoking in the pathogenesis of lung cancer is clearly established; there are other risk factors including hormones that make women more susceptible to carcinogens of tobacco. Other geographical and environmental factors could be incriminated including domestic smoke exposure especially in our context.

Health risks associated with the production and usage of charcoal: a systematic review

“…The oldest included studies were published in 1989 (n=2) 48 58. Most of the studies were on adults only,22 24 27 33 34 36 38–52 54–69 while two were conducted on a combined population of adults and children 35 37. Only one study included only children between 3 and 7 months old 53.…”

“…Only one study included only children between 3 and 7 months old 53. Overall, most of the studies were conducted among males and females (n=25),24 27 33 36–39 43–47 49–53 55 57 59–61 63 64 68 five were conducted among male-only participants22 40–42 66 and six were conducted among females only participants 34 35 56 62 65 69…”

“…Twenty-seven studies34–37 42 44–49 51–57 59 60 62–64 66 68 69 were conducted among charcoal users. The majority used charcoal for cooking only (n=20)34–37 42 44–46 48 51–54 56 57 59 65 66 68 69 ; three used charcoal for heating and cooking,47 49 55 while three studies reported that charcoal was used for medication,60 tooth brushing63 and cigarette filters 64.…”

“…Thirteen studies22 24 27 33 38–41 43 50 58 61 67 were conducted among charcoal producers. The settings of the included studies varied between urban (n=7),24 37 42 43 56 57 64 rural (n=5),38 45 46 51 61 combined rural and urban (n=5),34 36 54 55 69 hospital (n=5),35 44 60 62 63 community (n=3)53 66 68 and workplace (n=10) 22 27 33 39–41 48 50 58 67…”

“…Most studies reported respiratory outcomes (n=21) 22 24 27 33 36–39 43–46 50 53 55–59 66 68. Three studies reported cancer,62–64 and DNA damage,40 48 67 two studies reported CO poisoning,47 65 physical injury,41 61 and reduced body weight and body mass index (BMI) 34 35. One study reported sick house syndrome,52 cardiorespiratory and neurologic symptoms,54 increased blood pressure69 and CO-related death.…”