Determinants and Histopathologic Patterns of Lung Cancer at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia: A Six Year Retrospective Case‒Control Study, 2024

Background Lung cancer is the leading cause of cancer-related death globally, accounting for 1.8 million deaths annually. Its incidence is increasing in low- and middle-income countries (LMICs), including Ethiopia, where it comprises 1.5% of all cancers. Despite this, lung cancer remains locally underresearched. Objective To assess the determining factors and histopathological patterns of lung cancer at St. Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia. Method A hospital-based case‒control study involving 105 participants (35 cases and 70 controls) selected from histopathology-confirmed lung biopsies was conducted from January 2024 to January 2025. The Data were cleaned via EPI Data and analyzed via SPSS version-26. Descriptive statistics were used to summarize the findings, and Fisher’s exact test with odds ratios was used to identify determinants, as the sample size was insufficient for logistic regression modeling. Results The mean age was 43.83 years, with near-gender parity (M:F ratio of 1.1:1); there was a slight female predominance (0.94:1). Most patients (61.1%) were diagnosed with stage IV disease. Common symptoms included cough (81.0%), dyspnea (68.6%), and chest pain (59.0%). Radiologic findings revealed mass lesions in 67.6% of the patients. Adenocarcinoma was the predominant histologic subtype (46%). Smoking (OR = 4.50, p = 0.001) and biomass fuel use (OR = 2.20, p = 0.048) were significant risk factors. Conclusion Lung cancer at SPHMMC affects relatively young patients with near gender parity. Late-stage presentation and strong associations with smoking and biomass exposure highlight the need for early detection, smoking cessation, and clean energy initiatives.