Lung cancer in Spain: information from the Thoracic Tumors Registry (TTR study)

Mariano Provencio, Enric Carcereny, Delvys Rodríguez-Abreu, Rafael López-Castro, María Guirado, Carlos Camps, Joaquim Bosch-Barrera, Rosario García-Campelo, Ana Laura Ortega-Granados, José Luis González-Larriba, Joaquín Casal-Rubio, Manuel Domine, Bartomeu Massutí, María Ángeles Sala, Reyes Bernabé, Juana Oramas, Elvira del Barco


Background: Lung cancer remains a leading cause of cancer incidence and mortality worldwide. Although Spain contributes to global statistics related to cancer, it is difficult to discern aspects linked to clinical presentation of the disease or molecular testing. The Thoracic Tumor Registry (TTR) was created with the aim of filling this gap.
Methods: Observational cohort multicenter study performed in Spain, including patients with lung cancer or other types of thoracic tumors undergoing active treatment or palliative care only. Enrollment took place between August 2016 and December 2018. The evaluation included a review of demographic, epidemiological, clinical and molecular data.
Results: A total of 6,600 patients diagnosed with non-small cell lung cancer (NSCLC) were recruited at 56 Spanish hospitals. The mean age at diagnosis was 64 years. The majority of patients (80%) presented with advanced disease, being adenocarcinoma the most frequent histological type. Up to 86% of patients were current- or ex-smokers, with men starting to smoke earlier than women (average age 17.9 vs. 19.2 years). Sixty-seven percent of patients underwent some type of molecular testing. Mutations in EGFR and KRAS genes were found in 18% and 28% of patients, respectively.
Conclusions: Our findings suggest that the TTR study accurately describes the clinical reality of lung cancer in Spain, including useful information on smoking status as well as molecular profiling and tumor histology, and can therefore be used to drive improvements in health care. Social and political pressure to reduce tobacco consumption among the population should be reinforced, particularly among youth.