Association of smoking exposure and sociodemographic factors with histological subtypes of bronchogenic carcinoma in upper Egypt

Abstract Background Lung cancer remains a leading cause of cancer-related mortality worldwide and poses a growing public health challenge in Egypt. Histopathological subtypes show varying associations with smoking behavior and sociodemographic factors, yet data from Upper Egypt remain scarce. Objective To determine the association between smoking exposure, smoking-related characteristics, and sociodemographic factors with non-adenocarcinoma compared with adenocarcinoma among patients with bronchogenic carcinoma. Patients and methods This case-case study was conducted at specialized oncology hospitals in Qena, Egypt, between May 2024 and October 2025, enrolling 150 patients: 50 with non-adenocarcinoma subtypes, including squamous cell carcinoma (SCC) and small-cell lung cancer (SCLC)—and 100 with adenocarcinoma. Sociodemographic and detailed smoking profiles were collected via structured face-to-face interviews, while clinical comorbidities and definitive histopathological classifications were extracted from validated medical records. Results Among 150 patients (50 non-adenocarcinomas and 100 adenocarcinomas), non-adenocarcinoma was significantly more common in males (96% vs. 73%, p < 0.001) and current smokers (84% vs. 62%, p < 0.001). Patients with non-adenocarcinoma had substantially higher cumulative smoking exposure than those with adenocarcinoma [70.5 (49.1–78.7) vs. 40.0 (36.0–45.0) pack-years, p < 0.001]. In multivariable logistic regression, smoking exposure > 40 pack-years was strongly associated with non-adenocarcinoma histology (adjusted OR = 19.37; 95% CI: 3.45–108.72). Conclusion This study provides crucial localized data from Egyptian patient population, demonstrating that higher cumulative smoking exposure is strongly associated with the non-adenocarcinoma histological subtype in bronchogenic carcinoma. Given these findings, targeted screening strategies and comprehensive smoking cessation programs in Egypt should prioritize patients exceeding these critical exposure thresholds to optimize early detection and intervention outcomes.