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Asia Pac J Clin Oncol. 2018 Apr;14(2):e71-e80. doi: 10.1111/ajco.12697. Epub 2017 Aug 1.

Effect of pre existing respiratory conditions on survival of lung cancer patients: A nationwide population-based cohort study.

Author information

1
National Cancer Control Institute, National Cancer Center, Goyang, Korea.
2
Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
3
Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea.
4
Department of Hospital Administration, Graduate School of Public Health, Yonsei University, Seoul, Korea.
5
Department of Healthcare Management, Eulji University, Seongnam, Korea.
6
Department of Internal Medicine, University of Nevada School of Medicine, Las Vegas, Nevada, USA.
7
Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Asan, Korea.

Abstract

BACKGROUND:

Common diseases with potential to increase the risk of death from lung cancer have so far not been studied in large populations.

METHODS:

We did a population-based retrospective cohort study using nationwide health insurance claims data from 2005 to 2012 in Korea including 205 403 lung cancer patients. Multivariate-adjusted hazard ratios (aHRs) of lung cancer mortality by presence, time intervals with lung cancer diagnosis and combinations of pre-existing chronic obstructive pulmonary disease (COPD), pneumonia, asthma and tuberculosis were calculated using the Cox-proportional hazards model.

RESULTS:

The total number of person-years of follow-up was 397 780 and 60.2% of patients died (mean survival 23.2 months after lung cancer diagnosis). Lung cancer patients with previous respiratory disease had increased aHR for mortality (COPD, hazard ratio [HR] = 1.32, CI 1.29-1.35; pneumonia, HR = 1.14, CI 1.08-1.19; and asthma, HR = 1.11, CI 1.06-1.16). Risks were positively associated with longer duration of pre-existing disease diagnosis; cases with >5 years since diagnosis compared to <2 years: COPD, HR = 2.91, CI 2.82-3.00; pneumonia, HR = 1.67, CI 1.51-1.85; asthma, HR = 1.56, CI 1.45-1.68; and tuberculosis, HR = 2.03, CI 1.90-2.17. Furthermore, elevated HRs of death were found among patients with multiple pre-existing co-morbidities.

CONCLUSION:

Hazards of death from lung cancer are significantly increased in cases with pre-existing lung disease, and worse with longer durations, and with multiple combinations before cancer diagnosis. Patients and physicians should be aware of these meaningful risk/prognostic factors for lung cancer when identifying high-risk patient groups.

KEYWORDS:

lung neoplasms; pre-existing condition; respiratory tract diseases; survival

PMID:
28762660
DOI:
10.1111/ajco.12697
[Indexed for MEDLINE]

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