Right versus left lung cancer: Findings from the Japanese cancer registry database

Abstract

Laterality, which is the biological difference between the left and right sides of the body, has been identified as a potential factor in cancer development and progression. Previous studies have suggested that lung cancer incidence may differ between the right and left lungs, influenced by anatomical, genetic, and environmental factors. In this study, we investigated the relationship among lung cancer laterality, incidence, and prognosis. This cohort study used data from the Chiba Prefecture Cancer Registry (2013–2020) and included 36,502 patients with primary lung cancer. Patient characteristics were compared between patients with right- and left-sided lung cancers. Kaplan-Meier survival curves, log-rank tests, and Cox proportional hazards models were used to assess laterality differences in mortality, adjusted for age, sex, summary stage, histological type, and other covariates. Right-sided lung cancer was more prevalent (60 %) than left-sided (40 %). The Cox model revealed a slightly higher mortality rate for right-sided lung cancer than for left-sided cancer (hazard ratio [HR]: 1.05, 95 % confidence interval [CI]: 1.02–1.08, p = 0.003). Sex-stratified analysis showed a higher mortality risk for male with right-sided cancer (HR: 1.08, 95 % CI: 1.04–1.12, p < 0.001) but no significant laterality difference in female. The higher prevalence of right-sided lung cancer may be due to anatomical differences and genetic factors, such as the higher prevalence of the L858R mutation. Although the clinical impact of laterality differences is minimal, these findings provide insights into lung cancer pathogenesis and may contribute to advancing personalized medicine.