The Impact of Coexisting Asthma, Chronic Obstructive Pulmonary Disease and Tuberculosis on Survival in Patients with Lung Squamous Cell Carcinoma

Abstract

BackgroundPulmonary diseases [asthma, chronic obstructive pulmonary disease (COPD), and tuberculosis (TB)] are associated with lung cancer mortality. However, the relationship between coexisting pulmonary diseases and survival in patients with lung squamous cell carcinoma (SqCC) has not been well defined.MethodsPatients newly diagnosed with SqCC between 2003 and 2008 were identified by linking the National Health Insurance Research Database and Taiwan Cancer Registry Database. Cases with SqCC were followed up until death, loss to follow-up, or study end in 2010. Information on health status, date of death and the main causes of death was ascertained from the National Death Registry Database. Cox proportional hazard regression was used to calculate the hazard ratio (HR) of coexisting asthma, COPD and/or TB.ResultsDuring the study period, a total of 5406 cases with SqCC were enrolled. For all cause-mortality, HRs were 1.08 [95% confidence interval (CI), 0.99–1.18], 1.04 (95% CI, 0.97–1.12), and 1.14 (95% CI, 1.00–1.31) for individuals with asthma, COPD, and TB, respectively. Specifically, among men with coexisting pulmonary diseases, the HRs were 1.56 (95% CI, 1.23–1.97) and 1.11 (95% CI, 1.00–1.24) for individuals with asthma+COPD+TB and asthma+COPD, respectively. Among male patients with stage III SqCC, HRs were 3.41 (95%CI, 1.27–9.17) and 1.65 (95%CI, 1.10–2.47) for individuals with asthma+TB and asthma+COPD+TB, respectively. Among male patients with stage IV SqCC, HRs were 1.40 (95%CI, 1.00–1.97) and 1.25 (95%CI, 1.03–1.52) for individuals with asthma+ COPD+TB and asthma. Among female patients with stage I and II, HR was 0.19 (95%CI, 005–0.77) for individuals with asthma.ConclusionsCoexisting pulmonary diseases increased the risk of mortality from SqCC in male patients. For female patients with early stage SqCC, pre-existing asthma decreased mortality. These patients deserve greater attention while undergoing cancer treatment.

Asthma–Chronic Obstructive Pulmonary Diseases Overlap Syndrome Increases the Risk of Incident Tuberculosis: A National Cohort Study

“…This study included a cohort representing the general population. In Taiwan, before prescribing an inhaler, patients must be screened through the pulmonary function test (PFT), and a public nurse respiratory educates them regarding its use and avoiding the environmental factor, assess the nutrition status and evaluates the immune status.For diagnosing asthma [ 52 ] and COPD[ 53 ], the patient history, clinical manifestations, pulmonary function [ 53 ], and thoracic imaging indicate the diseases; in addition, consensus of the chest physician, rheumatologist, and immunologist[ 54 , 55 ] is required. After diagnosis, the inhaler [ 56 ] is prescribed under the strict policies of the NHI member.…”

“…coexistence of increased variability of airflow in a patient with incompletely reversible airway obstruction) [ 51 ] at least 2 times under the services of multidisciplinary team. The chest physician [ 54 , 55 ] must be trained by the Taiwan Society of Pulmonary and Critical Care Medicine, Taiwan Association of Asthmatics, Taiwan Association of Chronic Obstructive Pulmonary Disease, or the Chinese of Society of Immunology. Similarly, the coding of TB requires a consensus of well-trained chest specialists and infection specialists as well as review against the Centers for Disease Control and Prevention criteria.…”

Overall survival of driver mutation-negative non-small cell lung cancer patients with COPD under chemotherapy compared to non-COPD non-small cell lung cancer patients

“…Most previous studies evaluating the correlation between COPD and lung cancer were performed in populations who were heterogeneous in terms of lung cancer stage and treatment modalities. 16 , 18 Technical developments over the past decade have afforded options for targeted therapy of NSCLC patients, and median survival is longer in NSCLC patients with driver mutations compared to those without such mutations. 19 However, the proportion of patients positive for driver mutations is relatively small, and conventional chemotherapy, mostly platinum-based regimens, is still the mainstay first-line treatment for advanced NSCLC.…”

Post-Inhaled Corticosteroid Pulmonary Tuberculosis Increases Lung Cancer in Patients with Asthma

“…TB [ 17 ] and pneumonia [ 7 ] are risk factors of lung cancer. Co-existing asthma and TB has increased the incidence and mortality of lung cancer [ 5 , 18 , 19 ]. The relationship between pneumonia and TB and lung cancer in asthmatics with ICS use remains unclear.…”