Introduction:
Τo provide insights on Lung Cancer (LC) and the associated risk factors before-after the economic crisis in Crete, Greece. To assess the smoking habits of LC patients during the austerity period.

Material and Methods:
The study was conducted in Crete, Greece. Data (5,057 LC cases) were obtained from the Cancer Registry of Crete (CRC). Age-Standardized Incidence and Mortality Rates (ASIR, ASMR/100,000/year), adjusted Charlson’s Comorbidity Index (CCI%), deprivation index (HPI-2) and exposure to Outdoor Air Pollution (OAP) were estimated. The analysis was performed for two time periods (Period A: 1992-2008; Period B: 2009-2013).

Results:
ASIR presented a significant increase during the economic crisis, while even higher increase was observed in ASMR (Period A: ASMR=30.5/100,000/year; Period B: ASMR=43.8/100,000/year; p<0.001). A significant increase was also observed in smokers (Variation rate=7.4; p=0.02) during the austerity period. After 2009, a significant increase of the LC hot spots was observed in several sub-regions of Crete (p=0.04), mainly due to smoking and deprivation levels increase. The risk of LC mortality increased even more among smokers (RR=5.7; 95%CI=5.2-6.3) and individuals living in highly deprived geographical regions (RR=5.4; 95%=5.1-5.8) during the austerity period. The impact of the multiple LC predictors resulted in adjusted RRs ranging from 0.7 to 5.7 within the island (p<0.05).

Conclusions:
The increased LC burden after the onset of the economic crisis, along with a changing pattern of LC predictors stress the urgent need of targeted interventions and cancer control programs focusing on the most deprived or vulnerable population groups.