Demographic and clinical characteristics of primary lung cancer patients in Kerala: Analysis of data from six teaching centers.

in Lucknow showed a similar drastic difference between male and female smokers in India.[ 17 ] However, Western studies show that an increasing trend of female smokers is resulting in identical risk between men and women.[ 2 ] In addition, 52% of the smokers in our study population continue to smoke, which can increase the all-cause mortality, recurrence, and development of new primary cancers.[ 18 ] Our study also shows that 34% were nonsmokers; among which; incidence of lung cancer in females (55.2%) was higher than in males (44.7%).

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The M:F ratio in our study is higher than the Indian Council of Medical Research (ICMR) cancer registry data showing a decreasing trend in M:F ratio from 4.5 in 2002 to 3.1 in 2021.[ 11 ] This similar decrease in M:F ratio is supported by many studies in the United States indicating that the incidence curve of females is plateauing while that for males is decreasing.[ 12 - 14 ] Since first described in 1912, cigarette smoke inhalation is the major cause of lung cancer amounting to up to 90% of all causes.[ 3 , 4 , 15 , 16 ] In addition, 55.3% of the patients were smokers with a large majority being males (55.1%) and just 0.13% constituting females.

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