Environmental and occupational exposure in newly diagnosed lung cancer - data from the PROTEON study.

Background: Environmental (E) and occupational (O) lung cancer (LC) is under-reported. Raising the awareness for this problem could help optimize prevention and screening.

Methods: In 181 consecutive non-small cell LC patients (January 2023-December 2024, University Hospital of Liège, Belgium) E risk factors (RF) and ORF were collected through a self-reporting questionnaire (open and direct questions) with sociodemographic, tumor- and work-related data. The primary objective was to identify ERF and ORF prevalence.

Results: Mean age was 68.2 ± 8.8 years, 55.8% males, 93.4% (former) smokers. Half of the patients (53%) lived in (peri-)urban areas. 50% disclosed an obstructive airway disease and 31.5% had a positive LC family history. Of the 270 jobs registered, 78.5% were manual. Only 23.8% of the workers used protective equipment. 72.4% of the patients reported exposure to at least one ORF through direct questions, and the most frequent pulmonary carcinogens were asbestos (36.5%), silica (22.1%), welding fumes (15.5%), polycyclic aromatic hydrocarbons (14.9%), and diesel engine exhaust (14.4%). Overall, 93.9% of patients reported at least one E/ORF other than tobacco. A request for compensation was introduced in <3% of the patients.

Conclusion: Non-tobacco RF for LC are virtually always present in non-small cell LC patients and under-reported.

Trial registration: ClinicalTrials.gov (NCT00005602,259).