COPD raises lung cancer risk, regardless of smoking history

  • Park HY & al.
  • Thorax
  • 2 Apr 2020

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • COPD significantly increases the risk for lung cancer, even among those who have never smoked.
  • Lung cancer risk among never-smokers with COPD was similar to the risk among ever-smokers without COPD.

Why this matters

  • Up to 39% of patients with COPD have never smoked.
  • Patients with COPD might be good candidates for lung cancer screening, regardless of smoking history.

Study design

  • 338,548 participants aged 40-84 years in the National Health Insurance Service National Sample Cohort in Korea.
  • Funding: National Research Foundation of Korea.

Key results

  • 12,379 patients had COPD.
  • Patients with COPD were older and more likely to be male and smokers, and to have a lower income and more comorbidities (P<.001 for all>
  • During median 7-year follow-up, lung cancer was diagnosed in 290 patients with COPD (4.9 cases/1000 person-years) and 1544 without COPD (0.7 cases/1000 person-years).
  • Compared with never-smokers without COPD, lung cancer risk was greater in:
    • Never-smokers with COPD: HR, 2.67 (95% CI, 2.09-3.40).
    • Ever-smokers without COPD: HR, 1.97 (95% CI, 1.75-2.21).
    • Ever-smokers with COPD: HR, 6.19 (95% CI, 5.04-7.61).

Limitations

  • No data on COPD severity and lung cancer incidence.