Chronic obstructive pulmonary disease and altered risk of lung cancer in a population-based case-control study.
BACKGROUND
Chronic obstructive pulmonary disease (COPD) has been consistently associated with increased risk of lung cancer. However, previous studies have had limited ability to determine whether the association is due to smoking.


RESULTS
The Environment And Genetics in Lung cancer Etiology (EAGLE) population-based case-control study recruited 2100 cases and 2120 controls, of whom 1934 cases and 2108 controls reported about diagnosis of chronic bronchitis, emphysema, COPD (chronic bronchitis and/or emphysema), or asthma more than 1 year before enrollment. We estimated odds ratios (OR) and 95% confidence intervals (CI) using logistic regression. After adjustment for smoking, other previous lung diseases, and study design variables, lung cancer risk was elevated among individuals with a history of chronic bronchitis (OR = 2.0, 95% CI = 1.5-2.5), emphysema (OR = 1.9, 95% CI = 1.4-2.8), or COPD (OR = 2.5, 95% CI = 2.0-3.1). Among current smokers, association between chronic bronchitis and lung cancer was strongest among lighter smokers. Asthma was associated with a decreased risk of lung cancer in males (OR = 0.48, 95% CI = 0.30-0.78).


CONCLUSIONS
These results suggest that the associations of personal history of chronic bronchitis, emphysema, and COPD with increased risk of lung cancer are not entirely due to smoking. Inflammatory processes may both contribute to COPD and be important for lung carcinogenesis.
Koshiol
Jill
J
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, United States of America. koshiolj@mail.nih.gov
Rotunno
Melissa
M
Consonni
Dario
D
Pesatori
Angela Cecilia
AC
De Matteis
Sara
S
Goldstein
Alisa M
AM
Chaturvedi
Anil K
AK
Wacholder
Sholom
S
Landi
Maria Teresa
MT
Lubin
Jay H
JH
Caporaso
Neil E
NE
D000328:Adult; D000368:Aged; D001249:Asthma / Q000150:complications; D029481:Bronchitis, Chronic / Q000150:complications; D016022:Case-Control Studies; D004646:Emphysema / Q000150:complications; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000209:etiology*; D012044:Regression Analysis; D012306:Risk