PREVALENCE OF LUNG MALIGNANCIES IN PATIENTS WITH INTERSTITIAL LUNG DISEASE IN RURAL APPALACHIA

SESSION TITLE: Lung Pathology Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: Lung cancer and interstitial lung diseases (ILDs) are two distinct respiratory conditions that significantly impact patients. While they are typically studied and treated as separate diseases, recent research has shed light on the potential link between the two conditions. Studies have shown that people with preexisting ILDs are more prone to developing lung cancer. Therefore, our study seeks to identify the frequency of lung cancer among this patient population and determine the specific type of lung malignancy most associated with ILDs. A similar study in Appalachian Kentucky showed an increased prevalence of small and squamous cell cancers among similar populations. METHODS: We conducted a retrospective observational study to identify and characterize patients with ILD (Interstitial Lung Disease) who developed lung cancer after being diagnosed with ILD. A system-wide electronic medical records search was performed to identify all adult patients diagnosed with interstitial lung disease and lung cancer within the West Virginia University (WVU) health system as of January 1, 2020. Included charts were reviewed for occupational exposure, tobacco use, ILD diagnosis, cancer diagnosis, cancer staging, and subtype. Patients with lung cancer diagnosis preceding ILD diagnosis were excluded. REDCAP (Research electronic data capture) was used for data collection and tabulation. RESULTS: Of 535 patients filtered initially, 72 patients were included. 54 were male and 18 were female. The mean age of diagnosis of ILD was 67. 43 (60%) patients had documented occupational exposure and 66 (91%) were tobacco smokers. 23 (32%) had adenocarcinoma, 22 (30%) had SCC, and 10 (14%) had small cell carcinoma. Of patients where lung cancer stage was available, 45(69%) had stage III or IV cancer, while only 20(31%) were diagnosed at an early stage (Stage I or II). CONCLUSIONS: Lung cancer is the leading cause of mortality among all solid organ malignancies in the adult population. Early identification of treatable causes and prompt therapy can potentially prevent severe consequences. While a connection between lung cancer and ILD has been established, further studies to identify specific types and timelines to progression are needed. In our cohort, the types of lung cancer identified and stages at diagnosis in patients with ILD are similar to those of the general population. However, our cohort has a significant incidence of tobacco abuse which may portend an even greater risk of malignancy in patients with ILD. CLINICAL IMPLICATIONS: The high prevalence of various pulmonary risk factors such as occupational exposure, poverty, and smoking rates in the rural Appalachian population increases the risk of interstitial lung disease and lung cancer. A multilevel approach to identify at-risk individuals and areas for intervention combined with improved screening and early intervention could decrease morbidity and mortality rates associated with these diseases. The patients in our cohort were diagnosed at an advanced stage, underlining the need for more robust screening. Further studies are needed to elucidate the association of ILDs with malignancy. There is potential for larger patient population studies, histopathological investigations, and radiographic analyses that may function to improve our understanding of these two disease groups. DISCLOSURES: No relevant relationships by Haroon Ahmed No relevant relationships by Sana Ali No relevant relationships by Jacob Gelman No relevant relationships by Salwa Khan No relevant relationships by Rafia Zulfikar