Emphysema subtype tied to higher odds of lung cancer

  • González J & al.
  • PLoS ONE
  • 1 Jan 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Smokers with more severe emphysema or the centrilobular emphysema subtype have significantly higher odds of lung cancer.
  • The association between COPD and lung cancer risk may be mediated by emphysema rather than airflow obstruction.

Why this matters

  • This study is the first to examine the link between emphysema subtype and lung cancer risk.

Study design

  • 72 patients with lung cancer, matched 1:3 with 216 control individuals on the basis of age, sex, smoking history, and BMI.
  • Funding: Spanish Ministry of Economy and Competitiveness; others.

Key results

  • Visually determined emphysema was significantly associated with increased lung cancer risk (OR, 5.9; P<.0001 especially among the most severe emphysema cases ci>
  • Visual emphysema remained strongly associated with lung cancer risk after adjusting for COPD GOLD classification (aOR, 5.4; P<.0001>
  • Airflow obstruction was not associated with lung cancer risk after adjusting for the presence of visual emphysema.
  • The centrilobular subtype offered the greatest risk for lung cancer when present alone (OR, 34.27; 95% CI, 25.48-99.31), but was attenuated in the presence of paraseptal subtype (OR, 4.02; 95% CI, 3.61-34.97).
  • No association between paraseptal emphysema alone and increased lung cancer risk.

Limitations

  • Significantly more men than women in the lung cancer case cohort.