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