Frequency and Analysis of Risk Factors for Fungal Infections in Lung Cancer Patients

Lung cancer remains a major cause of cancer-related mortality globally. Fungal infections represent a serious complication in lung cancer patients, potentially affecting treatment outcomes and survival. However, data on their frequency and associated risk factors are limited, especially in developing countries like Indonesia. This study aimed to determine the frequency and analyze risk factors for fungal infections in lung cancer patients at Dr. Wahidin Sudirohusodo Hospital, Makassar. A cross-sectional design was used, with secondary data obtained from patient medical records and primary data from mycological and bronchial lavage culture examinations. Data collection occurred from July to September 2024 using purposive sampling. Ethical clearance was granted by the Health Research Ethics Commission, Faculty of Medicine, Hasanuddin University. Most patients were male, aged ≤60 years, with a smoking history and normal BMI. Comorbidities included diabetes mellitus (16.8%), COPD (14.5%), tuberculosis (18.2%), HIV (4.5%), and corticosteroid use (11.8%). Fungal infections were identified in 89.0% of patients, with 57.0% classified as probable and 32.0% as possible cases. The most frequently isolated fungi were Candida albicans, Aspergillus fumigatus, Candida glabrata, and Candida tropicalis, along with other species such as Candida dubliniensis, Candida krusei, Candida firmetaria, Aspergillus niger, and Cryptococcus neoformans. Significant risk factors included low BMI, absence of diabetes mellitus, EGFR mutations, and prolonged corticosteroid use (>4 weeks). These findings highlight the high prevalence of fungal infections in lung cancer patients and emphasize the importance of identifying risk factors for early diagnosis and management.