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Am J Respir Crit Care Med. 2014 Sep 1;190(5):549-59. doi: 10.1164/rccm.201402-0338OC.

Is previous respiratory disease a risk factor for lung cancer?

Author information

1
1 International Agency for Research on Cancer, Lyon, France.

Abstract

RATIONALE:

Previous respiratory diseases have been associated with increased risk of lung cancer. Respiratory conditions often co-occur and few studies have investigated multiple conditions simultaneously.

OBJECTIVES:

Investigate lung cancer risk associated with chronic bronchitis, emphysema, tuberculosis, pneumonia, and asthma.

METHODS:

The SYNERGY project pooled information on previous respiratory diseases from 12,739 case subjects and 14,945 control subjects from 7 case-control studies conducted in Europe and Canada. Multivariate logistic regression models were used to investigate the relationship between individual diseases adjusting for co-occurring conditions, and patterns of respiratory disease diagnoses and lung cancer. Analyses were stratified by sex, and adjusted for age, center, ever-employed in a high-risk occupation, education, smoking status, cigarette pack-years, and time since quitting smoking.

MEASUREMENTS AND MAIN RESULTS:

Chronic bronchitis and emphysema were positively associated with lung cancer, after accounting for other respiratory diseases and smoking (e.g., in men: odds ratio [OR], 1.33; 95% confidence interval [CI], 1.20-1.48 and OR, 1.50; 95% CI, 1.21-1.87, respectively). A positive relationship was observed between lung cancer and pneumonia diagnosed 2 years or less before lung cancer (OR, 3.31; 95% CI, 2.33-4.70 for men), but not longer. Co-occurrence of chronic bronchitis and emphysema and/or pneumonia had a stronger positive association with lung cancer than chronic bronchitis "only." Asthma had an inverse association with lung cancer, the association being stronger with an asthma diagnosis 5 years or more before lung cancer compared with shorter.

CONCLUSIONS:

Findings from this large international case-control consortium indicate that after accounting for co-occurring respiratory diseases, chronic bronchitis and emphysema continue to have a positive association with lung cancer.

KEYWORDS:

case–control study; data pooling; epidemiologic study; lung neoplasm; pulmonary disease

PMID:
25054566
PMCID:
PMC4214084
DOI:
10.1164/rccm.201402-0338OC
[Indexed for MEDLINE]
Free PMC Article

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