Diagnosing lung malignancy from bronchoscopy in Malta : an update

Abstract

Introduction: A previous local study by Agius et al. published in MMJ in 20091 identified a rise in lung adenocarcinoma over a decade, as well as an increasing number of females diagnosed with lung malignancy.

Aims and Objectives: The aim of this retrospective study was to further compare trends in lung malignancy diagnosis made from bronchoscopy in Malta to previous local data.

Materials and Methods: All bronchoscopies performed by one respiratory firm at Mater Dei Hospital in 2014-2015 were analysed, excluding those performed in intensive care. Cytology and histology results were retrieved and compared to those obtained from previously studied timeframes. Patients who had a post-bronchoscopy diagnosis via other means, were noted in order to calculate the bronchoscopy pick-up rate.

Results: 118 bronchoscopies were performed, 101 of which were done for suspected malignancy. 48 patients were diagnosed with lung malignancy from bronchoscopy in 2014-2015 by this respiratory firm. When compared to 2006-2007, 83.3% were males (vs 75%) and 16.7% were females (vs 25%). The overall bronchoscopy pick-up rate for malignancy was 81.4%. The most common histological diagnoses, when compared to 8 years previously, were adenocarcinoma 35.4% vs 27.8% (males 37.5% vs 31%; females 25% vs 14.3%), squamous cell 35.4% vs 44.4% (males 37.5% vs 44.8%; females 25% vs 42.9%), and small cell 14.6% vs 13.9%.

Conclusion: Adenocarcinoma has shown an upward trend in both gender groups, having now reached a similar prevalence to squamous cell carcinoma, which appears to be decreasing in both males and females in the Maltese population.