Previous Lung Diseases and Lung Cancer Risk: A Pooled Analysis From the International Lung Cancer Consortium

Abstract

To clarify the role of previous lung diseases (chronic bronchitis, emphysema, pneumonia, and tuberculosis) in the development of lung cancer, the authors conducted a pooled analysis of studies in the International Lung Cancer Consortium. Seventeen studies including 24,607 cases and 81,829 controls (noncases), mainly conducted in Europe and North America, were included (1984-2011). Using self-reported data on previous diagnoses of lung diseases, the authors derived study-specific effect estimates by means of logistic regression models or Cox proportional hazards models adjusted for age, sex, and cumulative tobacco smoking. Estimates were pooled using random-effects models. Analyses stratified by smoking status and histology were also conducted. A history of emphysema conferred a 2.44-fold increased risk of lung cancer (95% confidence interval (CI): 1.64, 3.62 (16 studies)). A history of chronic bronchitis conferred a relative risk of 1.47 (95% CI: 1.29, 1.68 (13 studies)). Tuberculosis (relative risk = 1.48, 95% CI: 1.17, 1.87 (16 studies)) and pneumonia (relative risk = 1.57, 95% CI: 1.22, 2.01 (12 studies)) were also associated with lung cancer risk. Among never smokers, elevated risks were observed for emphysema, pneumonia, and tuberculosis. These results suggest that previous lung diseases influence lung cancer risk independently of tobacco use and that these diseases are important for assessing individual risk.

LLPi: Liverpool Lung Project Risk Prediction Model for Lung Cancer Incidence

“…COPD was the only significant covariate in our final multivariable model. The association between COPD and lung cancer we found in our study was consistent with the result from two earlier meta-analyses (17,39). In contrast, emphysema, bronchitis, pneumonia, asthma, and tuberculosis were not significantly associated with lung cancer in our final multivariate model.…”

“…Previous lung diseases, including COPD (emphysema, bronchitis), tuberculosis, pneumonia (39), and asthma (40), have been reported as risk factors for lung cancer. In our study, we also examined the association among COPD, emphysema, bronchitis, pneumonia, tuberculosis, and asthma on lung cancer.…”

The UK Lung Cancer Screening Trial: a pilot randomised controlled trial of low-dose computed tomography screening for the early detection of lung cancer

“…chronic obstructive pulmonary disease (COPD), chronic bronchitis, emphysema, tuberculosis and pneumonia]. 7,8 Lung cancer is more common in people from deprived socioeconomic groups: 9 people from the most deprived socioeconomic quintile in England are 2.5 times as likely to develop lung cancer as those from the highest quintile (after adjusting for age; 2000-4 figures).…”

Cancer incidence and mortality among members of the Danish resistance movement deported to German concentration camps: 65‐Year follow‐up

“…The higher risk for lung cancer might be due to the high incidence of tuberculosis among exprisoners (16% in Denmark 4 and 15% in Norway 13 ) or other lung diseases during and after deportation or the combined effect of smoking and alcohol consumption. 15,16 We do not have information on smoking-and alcohol consumption at an individual level, but high alcohol consumption has been reported in selected groups of Danish and Norwegian exprisoners. 4,13 The high death rate (14%) in the camps and shortly after the prisoners' return, highest among the oldest prisoners, might have introduced heterogeneity due to selection of the cohort by survival.…”