Low Lung Function and Incident Lung Cancer in the United States

Mannino, David M.; Aguayo, Samuel M.; Petty, Thomas L.; Redd, Stephen C.

doi:10.1001/archinte.163.12.1475

Cited by 300 publications

(118 citation statements)

References 27 publications

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“…This shows that compared to screening participants with normal lungs, detection rates were 4-5-fold greater in those with spirometry-based COPD or CTbased emphysema. These findings are supported by a large prospective study by MANNINO et al [7] showing over a 20 yr follow-up that lung cancer occurred 5-fold more frequently in those with spirometry-based COPD compared with normal lung function. Lastly, BECHTEL et al [8] screened exclusively current/ former smokers with COPD in a 1 yr community-based CT screening study and reported a lung cancer detection rate of 4-6%.…”

Section: To the Editorssupporting

confidence: 70%

“…However, there is growing data to suggest that a ''COPD-based'' (but not exclusive) approach to help define screening eligibility might substantially improve these rates ( fig. 1) [4,7,8]. The Pittsburgh (PA, USA) study is the only CT screening study to date that has published the results of spirometry-defined COPD and CT-based emphysema in both the screened cohort and lung cancer cases [4].…”

Section: To the Editorsmentioning

confidence: 99%

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Diagnosing COPD and targeted lung cancer screening: Figure 1–

Young

2012

Eur Respir J

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Section: To the Editorssupporting

confidence: 70%

Section: To the Editorsmentioning

confidence: 99%

Diagnosing COPD and targeted lung cancer screening: Figure 1–

Young

2012

Eur Respir J

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“…Within this group, 50-90% of them will have pre-existing COPD. We and others have shown previously that smokers with reduced airflow, namely FEV1 consistent with COPD (GOLD stage II or higher), carry a fourto six-fold greater risk of lung cancer compared with smokers with normal lung function [5][6][7]. We conclude that FEV1 is a very good marker for susceptibility to lung cancer [7,52].…”

Section: Discussionsupporting

confidence: 54%

“…inflammation, tissue remodelling and oxidant load. As such, they should not be considered in isolation but, rather, as two interrelated diseases [5][6][7] with overlapping genetic effects [30]. Approximately 10-15% of smokers will be diagnosed with lung cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Epidemiological studies show that ,20-30% of smokers develop COPD, while 10-15% develop lung cancer [3,4]. We and others have shown that COPD confers a four-to six-fold increased risk of lung cancer compared to smokers with normal lung function [5][6][7], and that 50-90% of those with lung cancer have preexisting COPD [5,[8][9][10]. The latter compares with 15% in randomly selected, community-based smoking controls [5].…”

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confidence: 92%

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Chromosome 4q31 locus in COPD is also associated with lung cancer

Young

Whittington²,

Hopkins³

et al. 2010

European Respiratory Journal

100

110

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Chronic obstructive pulmonary disease (COPD) is the single greatest risk factor for lung cancer in smokers and is found in 50-90% of lung cancer cases. The link between COPD and lung cancer may stem in part from the matrix remodelling and repair processes underlying COPD, and the development of epithelial-mesenchymal transition (EMT) that underlies lung carcinogenesis. The Hedgehog-interacting protein (HHIP), which mediates the epithelial response (EMT) to smoking, has been implicated in COPD and lung cancer. Recent genomewide and candidate gene studies of COPD implicate genetic variants on the chromosomal 4q31 (HHIP/glycophorin A (GYPA)) locus.In a case-control study of smokers with normal lung function, COPD and lung cancer (subphenotyped for COPD), we show the GG genotype of the rs 1489759 HHIP single-nucleotide polymorphism (SNP) and the CC genotype of the rs 2202507 GYPA SNP confers a ''protective'' effect on COPD (OR 0.59, p50.006 for HHIP and OR50.65, p50.006 for GYPA) and lung cancer (OR50.70 (p50.05) for HHIP and OR 0.70 (p50.02) for GYPA).This study suggests that, in smokers, genetic variants of the 4q31 locus conferring a protective effect for COPD are also protective in lung cancer. We conclude that genetic susceptibility to lung cancer includes COPD-related gene variants.

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Computed Tomography Screening and Lung Cancer Outcomes

Bach¹

2007

JAMA

506

252

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Context Current and former smokers are currently being screened for lung cancer with computed tomography (CT), although there are limited data on the effect screening has on lung cancer outcomes. Randomized controlled trials assessing CT screening are currently under way. Objective To assess whether screening may increase the frequency of lung cancer diagnosis and lung cancer resection or may reduce the risk of a diagnosis of advanced lung cancer or death from lung cancer. Design, Setting, and Participants Longitudinal analysis of 3246 asymptomatic current or former smokers screened for lung cancer beginning in 1998 either at 1 of 2 academic medical centers in the United States or an academic medical center in Italy with follow-up for a median of 3.9 years. Intervention Annual CT scans with comprehensive evaluation and treatment of detected nodules. Main Outcome Measures Comparison of predicted with observed number of new lung cancer cases, lung cancer resections, advanced lung cancer cases, and deaths from lung cancer. Results There were 144 individuals diagnosed with lung cancer compared with 44.5 expected cases (relative risk [RR], 3.2; 95% confidence interval [CI], 2.7-3.8; PϽ.001). There were 109 individuals who had a lung resection compared with 10.9 expected cases (RR, 10.0; 95% CI, 8.2-11.9; PϽ.001). There was no evidence of a decline in the number of diagnoses of advanced lung cancers (42 individuals compared with 33.4 expected cases) or deaths from lung cancer (38 deaths due to lung cancer observed and 38.8 expected; RR, 1.0; 95% CI, 0.7-1.3; P=.90). Conclusions Screening for lung cancer with low-dose CT may increase the rate of lung cancer diagnosis and treatment, but may not meaningfully reduce the risk of advanced lung cancer or death from lung cancer. Until more conclusive data are available, asymptomatic individuals should not be screened outside of clinical research studies that have a reasonable likelihood of further clarifying the potential benefits and risks.

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Low Lung Function and Incident Lung Cancer in the United States

Abstract: The presence of moderate or severe obstructive lung disease is a significant predictor of incident lung cancer in long-term follow-up. This finding may be useful clinically and in studies evaluating the utility of new tools for the early detection of lung cancer.

Cited by 300 publications

References 27 publications

Diagnosing COPD and targeted lung cancer screening: Figure 1–

Diagnosing COPD and targeted lung cancer screening: Figure 1–

Chromosome 4q31 locus in COPD is also associated with lung cancer

Computed Tomography Screening and Lung Cancer Outcomes

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