Lung cancer remains the leading cause of cancer-related mortality worldwide, with approximately 2.5 million new cases and 1.8 million deaths each year. Although advances in diagnosis and treatment have improved patient outcomes, the disease continues to represent a major public health challenge, particularly in low- and middle-income countries, like Georgia, where most cases now occur.<\/p>\n
In our country, more than 1,200 new lung cancer cases are diagnosed annually, accounting for approximately 13% of all cancers in the country. Despite increasing access to modern therapies, most patients are still diagnosed at an advanced stage, limiting curative treatment options.<\/p>\n
The overwhelming scientific evidence confirms that tobacco smoking is the primary risk factor for lung cancer. Cigarette smoke contains more than 7,000 chemicals, including at least 70 known carcinogens, which damage DNA and promote malignant transformation. Worldwide, nearly 1.3 billion people smoke, with almost 80% living in low- and middle-income countries.<\/p>\n
To better understand the epidemiology of lung cancer in Georgia, we analyzed the clinical, pathological, and molecular characteristics of 270 patients diagnosed between 2023 and 2025, representing one of the largest real-world lung cancer cohorts reported from the country (Table 1, Figure 1).<\/p>\n
The results strongly reinforce the association between tobacco use and lung cancer. Eighty-eight percent of patients were current or former smokers, while 46% were heavy smokers consuming more than one pack of cigarettes per day. In other words, nearly nine out of ten Georgian lung cancer patients had a history of tobacco exposure.<\/p>\n
The study also highlighted the challenge of delayed diagnosis. Among smokers, 93% presented with metastatic disease at diagnosis, whereas only 7% were diagnosed at Stage I or II, when surgery offers the possibility of cure. These findings emphasize that lung cancer in Georgia is still detected far too late for many patients.<\/p>\n
Interestingly, adenocarcinoma, the most common histological subtype of lung cancer, was observed more frequently among never-smokers, consistent with international observations that the biological characteristics of lung cancer differ between smokers and non-smokers (Figure 2).<\/p>\n
Late diagnosis remains one of the greatest obstacles to improving survival. Early-stage lung cancer often causes no symptoms, while cough, shortness of breath, hemoptysis, chest pain, weight loss, and fatigue typically appear only after the disease has progressed. In our cohort, cough and dyspnea were the most common presenting symptoms, each reported in approximately 29% of patients. Waiting for symptoms to develop is therefore not an effective strategy for early detection.<\/p>\n
Recognizing this challenge, Georgia introduced a national lung cancer screening program in 2026, based on low-dose computed tomography (LDCT) for high-risk individuals. International studies have shown that LDCT screening significantly reduces lung cancer mortality by detecting tumors before symptoms appear. Given that only a small proportion of Georgian patients are currently diagnosed at an early stage, successful implementation of this program could substantially improve survival in the coming years.<\/p>\n
Another growing concern is the increasing popularity of electronic cigarettes, vaping devices, and heated tobacco products. Although these products may produce fewer combustion-related toxins than conventional cigarettes, they are not harmless. Their aerosols contain nicotine, ultrafine particles, heavy metals, volatile organic compounds, and other potentially toxic substances capable of causing airway inflammation and cellular injury. While their long-term effect on lung cancer risk is still under investigation, international oncology and respiratory societies do not consider these products safe, particularly for young people initiating nicotine use.<\/p>\n
Reducing the burden of lung cancer requires more than advances in treatment. Continued strengthening of tobacco control policies, expanded smoking cessation programs, prevention of vaping among adolescents, public education, and widespread participation in lung cancer screening are all essential components of an effective national strategy.<\/p>\n
Our findings clearly demonstrate that tobacco remains the dominant driver of lung cancer in Georgia and that most patients are diagnosed with advanced disease. The introduction of lung cancer screening represents an important step forward, but prevention remains the most effective intervention. The fight against lung cancer begins long before the oncology clinic, it begins with the decision never to smoke or to quit smoking as early as possible.<\/p>\n
Author: Ana Tsereteli, MD, Caucasus Medical Centre<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":" Lung cancer remains the leading cause of cancer-related mortality worldwide, with approximately 2.5 million new cases and 1.8 million deaths each year. Although advances in diagnosis and treatment have improved patient outcomes, the disease continues to represent a major public health challenge, particularly in low- and middle-income countries, like Georgia, where most cases now occur. […]<\/p>\n","protected":false},"author":12,"featured_media":21313,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5963],"tags":[6132,6131],"class_list":["post-21314","post","type-post","status-publish","format-standard","has-post-thumbnail","category-oncofeed-en","tag-ana-tsereteli","tag-lung-cancer"],"acf":[],"_links":{"self":[{"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/posts\/21314","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/comments?post=21314"}],"version-history":[{"count":1,"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/posts\/21314\/revisions"}],"predecessor-version":[{"id":21315,"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/posts\/21314\/revisions\/21315"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/media\/21313"}],"wp:attachment":[{"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/media?parent=21314"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/categories?post=21314"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medscriptum.org\/en\/wp-json\/wp\/v2\/tags?post=21314"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}