Date of Award

11-24-2021

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

Dr Uzma Shamsi

Second Advisor

Sir Iqbal Azam

Third Advisor

Dr Masooma Aqeel

Department

Community Health Sciences

Abstract

Background: Lung cancer is a common malignancy among smokers, however it’s incidence among non[1]smokers is seen to be rising during recent years particularly among developing countries. Bio[1]mass exposure, occupational exposures and their link with lung cancer need to be explored and understood in our setting so we can develop and implement public health policies regarding use of personal protective equipment (PPE) in high-risk occupations and promote use of cleaner fuels.
Methods: A case-control study was conducted in two tertiary care hospitals of Karachi. We recruited 117 cases and 234 controls. Controls were both population-based, and hospital based. Population based controls were the attendants of non-lung cancer patients, while hospital-based controls were patients coming to day-care surgery department. We conducted the study by taking in[1]person interviews as well as telephonic interviews of both the cases and controls. Various exposures including high-risk occupations, biomass exposure and other sociodemographic exposures were assessed. Multivariable logistic regression was employed to assess the association of lung cancer with these factors. Adjusted odds ratio (OR) along with 95% confidence intervals were reported.
Results: High risk occupations including list-A occupations (known carcinogens) and list-B occupations (suspected carcinogens) reported association with lung cancer with an odds ratio of 3.2 (95% CI: 1.23 - 8.33) for list-A occupations and an odds ratio of 5.3 (95% CI: 1 - 28.6) for list-B occupations. Association of lung cancer with moderate to heavy smokers was seen with an odds ratio of 9.16 (95% CI 3.35 - 25). Biomass exposure among those aged 55 and above (effect modification) was seen to be associated with lung cancer with an odds ratio of 16.5 (95% CI 1.09 - 248.51). BMI was seen to be inversely associated with lung cancer. Risk factors associated with lung cancer in adult population of Karachi, Pakistan.
Conclusion: Our study results confirmed the association of previously reported high-risk occupational exposures with lung cancer, along with biomass exposure, BMI, age, and smoking. The study gives an indication to limit high-risk occupational exposures and advocate workplace interventions. Mass awareness and educational campaigns along with policy implementation are needed regarding preventable risk factors including smoking cessation programs, use of personal protective equipment in high-risk occupations, screening of high-risk population and use of cleaner fuels to curtail the risk of lung cancer in population.

First Page

1

Last Page

105

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