title: Smoking, passive smoking and lung cancer cell types among women in Morocco: analysis of epidemiological profiling of 101 cases.
abstract: BACKGROUND
  Recently women's lung cancer mortality rates have dramatically increased in developed countries, contrasting with a levelling off or decrease among men. Descriptive epidemiological data on primary lung cancer in women is scarce in Morocco. The aim of this study, conducted in the National Institute of Oncology in Rabat, was to describe the epidemiological profiling especially for the smoking status, to determine the most frequent type of lung cancer, and to analyse the survival of Moroccan women with lung cancer diagnosis.
  
  
  RESULTS
  We found 101 women among 1680 (male and female) cases of lung cancer. The never-smokers were estimated to 75 %. The proportion of adenocarcinoma among never and passive smokers was higher than that of squamous cell carcinoma (SCC) (69.4 versus 30.6 %), while among women who were smokers, the most frequent histological type was SCC (63.6 %). The Cox regression analysis showed that smoking and passive smoking were not significantly associated with survival [HR: 0.62 (95 % CI 0.31, 1.30); p = 0.19] [HR: 0.56 (95 % CI 0.29, 1.08); p = 0.08] respectively. Adenocarcinoma was significantly associated with shorter survival [HR: 1.73 (95 % CI 1.05, 2.85); p = 0.03].
  
  
  CONCLUSIONS
  The majority Moroccan women affected by lung cancer have never smoked (75 %). Environmental exposures, genetic predisposition, hormonal factors, and viral infection may all play a role in lung cancer in this category. The relation between histological type and tobacco found in our series concurred with those reported in the literature--adenocarcinoma appears to be the most frequent cell type affecting never and passive smokers. Adenocarcinoma is significantly associated with poorer survival.
authors.affiliation: Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco. zora-83@hotmail.com.|Department of medical oncology, National Institute of Oncology, Agdal/Riad, 10000, Rabat, Morocco. zora-83@hotmail.com.
authors.forename: Fatima Az-zahra
authors.initials: FA
authors.lastname: Zakkouri
authors.affiliation: Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco. saloua.ouaouch@gmail.com.
authors.forename: Ouaouch
authors.initials: O
authors.lastname: Saloua
authors.affiliation: Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco. abahssainhalima@yahoo.fr.
authors.forename: Abahssain
authors.initials: A
authors.lastname: Halima
authors.affiliation: Laboratory of Biostatistics, Epidemiology and Clinical Research, Rabat, Morocco. razinerachid@yahoo.fr.
authors.forename: Razine
authors.initials: R
authors.lastname: Rachid
authors.affiliation: Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco. mrabti_h@yahoo.fr.
authors.forename: Mrabti
authors.initials: M
authors.lastname: Hind
authors.affiliation: Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco. h_errihani@yahoo.fr.
authors.forename: Errihani
authors.initials: E
authors.lastname: Hassan
mesh_terms: D018450:Disease Progression; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D008875:Middle Aged; D009018:Morocco / Q000453:epidemiology; D012907:Smoking / Q000009:adverse effects*; D016019:Survival Analysis; D013997:Time Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution