Abstract

Background: Cancers, including lung cancer, are often targets for tyrosine kinase inhibitors. The prevalence of EGFR mutations is known to vary by ethnicity, with higher rates in East Asian populations. Limited data exist on EGFR mutations in non-small cell lung cancer patients from Iraq.
Objective: To assess the prevalence of EGFR mutations in non-small cell lung cancer patients in Iraq and compare the mutation rates across age groups, sex, and cancer subtypes.
Methods: A cohort of 430 confirmed lung carcinoma cases from southern Iraq (2016-2023) was analyzed. DNA was extracted from paraffin-embedded samples, and EGFR mutations in exons 18, 19, 20, and 21 were detected using real-time PCR. The prevalence of EGFR mutations was stratified by age, sex, and cancer subtype.
Results: EGFR mutations were detected in 35.3% of the total cohort (152/430). The most frequent mutations were found in exon 19 (53.9%), followed by exon 21 (19.7%) and exon 18 (11.8%). Combined mutations in occurred at 9.2%. The prevalence of EGFR mutations was significantly higher in the 60-69 age group (42.1%) at p= 0.037*, followed by the 70-79 group (20.4%) and 50-59 group (18.4%). There was no significant sex difference p=0.2*, with mutation rates in males at 51.97% and females at 48.03%. Adenocarcinoma was the predominant cancer subtype (95.3%) associated with EGFR mutations.
Conclusion: EGFR mutations are prevalent in 35.3% of Iraqi lung cancer patients, a rate comparable to East Asian populations and higher than in other Middle Eastern countries. This highlights the need for further research into genetic predispositions and targeted therapies in Iraq. Understanding the high prevalence could guide treatment decisions and improve survival rates among Iraqi lung cancer patients.