Prevalence, risk factors and survival of lung cancer in the idiopathic pulmonary fibrosis

Abstract

Background: The aim of this study was to evaluate the prevalence, risk factors, and survival of lung cancer in patients with idiopathic pulmonary fibrosis (IPF). Methods: IPF with lung cancer from tertiary hospitals consisted of 1685 patients who had been diagnosed between 2003 and 2007. We reviewed their medical records retrospectively to evaluate the prevalence, risk factors and prognosis of lung cancer in IPF patients. Results: Among all patients with IPF, 114 cases (6.8%) had lung cancer with IPF. The incidence of lung cancer in patients with IPF was 1.03 persons per 100 person-year (25 patients/2408 years). Most cases of lung cancer (73/114, 68.9%) were located in IPF-associated areas; the lung cancer typically developed in peripheral and lower lobe areas. The study revealed that forced vital capacity (% predicted) at the initial diagnosis and development of lung cancer were independent prognostic factors in patients with IPF. Conclusions: Lung cancer in patients with IPF was significantly related with the IPF prognosis. An active evaluation should be performed in patients with IPF to detect lung cancer early.

Comorbidities in idiopathic pulmonary fibrosis patients: a systematic literature review

“…The prevalence of lung cancer among IPF patients was reported in 15 studies [26,28,34,48,[82][83][84][85][86][87][88][89][90][91][92] (online supplementary table S4 and figure 5) and was typically lower than the prevalence of other respiratory comorbidities of interest. Analyses of insurance claims and electronic medical records databases from the USA and the UK estimated the prevalence of lung cancer to be 3-4% [26,82,83].…”

“…30-day, 90-day, in-hospital) tended to be low (0 deaths [95,96], 4% [96,97], 5% [98], 7% [97], 8% [98,99], 12% [93,98]), although a small database review from China reported a post-operative mortality rate of 33.3% (two of six patients) [84]. Median survival from IPF diagnosis was between 7 (95% CI 2.51-11.49) and 26.9 months (95% CI 14.67-39.05) [84,89]. Two studies reported no significant difference in median survival between IPF-alone and IPF patients with lung cancer [84,85].…”

“…However, survival tended to be longer for the IPF-alone patients and those studies may have been limited by small sample sizes. A larger study found that IPF patients without lung cancer (n=1571) had a significantly longer survival time compared with IPF patients with cancer (n=114) (the survival time is presented in graphical format in the paper and the specific time for patients without lung cancer is not reported) [89]. The adjusted HR for death for lung cancer versus no lung cancer was reported as 2.4 (95% CI 1.4-4.3; p=0.002) [89].…”

“…A larger study found that IPF patients without lung cancer (n=1571) had a significantly longer survival time compared with IPF patients with cancer (n=114) (the survival time is presented in graphical format in the paper and the specific time for patients without lung cancer is not reported) [89]. The adjusted HR for death for lung cancer versus no lung cancer was reported as 2.4 (95% CI 1.4-4.3; p=0.002) [89]. In a retrospective Japanese single-centre study, histopathologically confirmed IPF was identified as a significant negative prognostic factor for post-operative mortality and long-term survival in 387 primary lung cancer patients treated by surgical resection [98].…”

Idiopathic Pulmonary Fibrosis Coexisting with Lung Cancer

“…Similar results were reported basing on a South Korean study sample, where lung cancer prevalence in IPF patients was 6.8%. Among 89 IPF subjects, a simultaneous diagnosis of lung cancer and IPF was established in 78.1% of cases [33].…”