Journal article
Features of COPD as Predictors of Lung Cancer
Chest, Vol.153(6), pp.1326-1335
06/2018
DOI: 10.1016/j.chest.2018.01.049
PMCID: PMC6026288
PMID: 29452098
Abstract
Lung cancer is a leading cause of death and hospitalization for patients with COPD. A detailed understanding of which clinical features of COPD increase risk is needed.
We performed a nested case-control study of Genetic Epidemiology of COPD (COPDGene) Study subjects with and without lung cancer, age 45 to 80 years, who smoked at least 10-pack years to identify clinical and imaging features of smokers, with and without COPD, that are associated with an increased risk of lung cancer. The baseline evaluation included spirometry, high-resolution chest CT scanning, and respiratory questionnaires. New lung cancer diagnoses were identified over 8 years of longitudinal follow-up. Cases of lung cancer were matched 1:4 with control subjects for age, race, sex, and smoking history. Multiple logistic regression analyses were used to determine features predictive of lung cancer.
Features associated with a future risk of lung cancer included decreased FEV
/FVC (OR, 1.28 per 10% decrease [95% CI, 1.12-1.46]), visual severity of emphysema (OR, 2.31, none-trace vs mild-advanced [95% CI, 1.41-3.86]), and respiratory exacerbations prior to study entry (OR, 1.39 per increased events [0, 1, and ≥ 2] [95% CI, 1.04-1.85]). Respiratory exacerbations were also associated with small-cell lung cancer histology (OR, 3.57 [95% CI, 1.47-10]).
The degree of COPD severity, including airflow obstruction, visual emphysema, and respiratory exacerbations, was independently predictive of lung cancer. These risk factors should be further studied as inclusion and exclusion criteria for the survival benefit of lung cancer screening. Studies are needed to determine if reduction in respiratory exacerbations among smokers can reduce the risk of lung cancer.
Details
- Title: Subtitle
- Features of COPD as Predictors of Lung Cancer
- Creators
- Laurie L Carr - Department of Medicine, National Jewish Health, Denver, CO. Electronic address: carrl@njhealth.orgSean Jacobson - Department of Medicine, National Jewish Health, Denver, CODavid A Lynch - Department of Radiology, National Jewish Health, Denver, COMarilyn G Foreman - Division of Pulmonary and Critical Care, Morehouse School of Medicine, Atlanta, GAEric L Flenaugh - Division of Pulmonary and Critical Care, Morehouse School of Medicine, Atlanta, GACraig P Hersh - Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MAFrank C Sciurba - Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PADavid O Wilson - Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PAJessica C Sieren - Department of Radiology, University of Iowa, Iowa City, IAPatrick Mulhall - Division of Pulmonary and Critical Care Medicine, Temple University Hospital, Philadelphia, PAVictor Kim - Division of Pulmonary and Critical Care Medicine, Temple University Hospital, Philadelphia, PAC Matthew Kinsey - Division of Pulmonary and Critical Care, University of Vermont College of Medicine, Burlington, VTRussell P Bowler - Department of Medicine, National Jewish Health, Denver, CO
- Resource Type
- Journal article
- Publication Details
- Chest, Vol.153(6), pp.1326-1335
- Publisher
- United States
- DOI
- 10.1016/j.chest.2018.01.049
- PMID
- 29452098
- PMCID
- PMC6026288
- ISSN
- 0012-3692
- eISSN
- 1931-3543
- Grant note
- U01 HL089856 / NHLBI NIH HHS P30 ES005605 / NIEHS NIH HHS U01 HL089897 / NHLBI NIH HHS R01 HL089856 / NHLBI NIH HHS K23 HL133476 / NHLBI NIH HHS R01 HL089897 / NHLBI NIH HHS U54 MD008149 / NIMHD NIH HHS R01 HL112986 / NHLBI NIH HHS P30 CA086862 / NCI NIH HHS
- Language
- English
- Date published
- 06/2018
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology
- Record Identifier
- 9984051765602771
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