Epidemiological analysis of Lung cancer in Erbil province of Iraqi Kurdistan: Incidence, Survival, Relative Risk Ratio, and Treatment Regimes in males and females

This study compares survival function, relative risk, incident rates and treatment regime between genders. A total of 590 cases of Lung Cancer admitted to Nanakali hospital, Erbil province of Iraqi Kurdistan, were collected for 5 years period between 1st January 2013 to 31st of December 2017. The follow-up of the cases continued till the 1st of April 2018 to complete the record. Chi-square, correlation, relative risks and basic exploratory data analysis were carried out. Simple linear regression was carries out for number of lung cancer among males and females. A multivariate Cox-regression model was used to determine the prognostic factors for lung cancer patients. Pearson’s Correlation Coefficient (r) for total cases of Lung cancer (Males and Females) was equal to (0.875 ± 0.033 with P= 0.044) and R-square (Precision) of 0.766. The Prediction Regression equation that Female Lung Cancer (F) = 11.79 + 0.6714 Age group. This means any age group can be selected to predict for expected incidence. The prediction equation is that Male Lung Cancer cases = - 2.857 + 0.7690 Age group. The Regression coefficient is + 0.769 per 10 years of age and it is highly significant (P=0001).The result of multivariable cox regression model indicates that gender had no influence on survival outcome (HR ~= 0.81, 95%CI: 0.56 to 1.16, p=0.0.247). However, taking surgery and immune system are statistically significant prognostic factors for lung cancer patients. The model indicated that the risk of mortality increases by 92% if lung cancer patients do not take surgery (HR ~= 1.92, 95%CI: 0.31 to 0.97, p=0.039). Furthermore, the risk of mortality is reduced by 44% among those patients who took immune system. The study concludes that female patients survive longer than males and median survival probability in female is greater than male lung cancer patients. Taking surgery and immune system are statistically significant prognostic factors for lung cancer patients.