Article Text
Abstract
Background There have been reports that lung cancer in non-smokers (LCINS) is increasing in the UK but it is unclear whether this simply reflects fewer people smoking cigarettes or changing environmental risk factors such as increased emissions from domestic combustion. We examined UK-wide sociodemographic trends in the incidence of LCINS.
Methods We identified a cohort of 3,679,831 people self-reporting to their general practice physician as non-smokers from The Health Improvement Network (THIN) IQVIA™ Medical Research Data. Using multivariable Poisson regression, we estimated gender-specific time-trends in the incidence of LCINS for 1998–2018 and explored the impact of geographic location, social deprivation and urban-rural classification.
Results The analysis included 3,121 cancer events and 16,051,244 person-years (PYs). Earlier time periods, high social deprivation, urban living, and residing in the North of England were associated with higher age-adjusted LCINS rates in men. Living in the North of England was the only clear risk factor for women. Between 1998–2008, age-adjusted rates in men declined by 9% per year (95%CI: 7–11%) from an estimated 5.6 to 1.5 per 10,000 PYs and then remained stable. These time trends for men were similar across sociodemographic variables. Between 1998 and 2007, incidence rates were stable for women at 1.3 per 10,000 PYs. However, for the least socially deprived rates increased by around 5% per year (95%CI: 2–9%) from an estimated 1.3 per 10,000 PYs in 2008 to 2.1 in 2018.
Conclusion The incidence of LCINS has reduced or remained stable for most of the UK with the exception of women living in the least socially deprived areas.