Self-reported cardiovascular disease and the risk of lung cancer, the HUNT study.
BACKGROUND
Inflammation is involved in development of lung cancer and cardiovascular disease (CVD), and we hypothesize that self-reported CVD is an independent risk factor for lung cancer.


METHODS
Data from the Nord-Trøndelag Health Study (1984-2008) linked to the Norwegian Cancer and Death Cause Registry were analyzed stratified by smoking status. In total, 97,087 persons (1,634,967 person years) were included (never smokers 567,575 person years, former smokers 295,685 person years, current smokers 444,922 person years, and unknown 326,785 person years) and followed for an average of 15 years. The proportional hazard model was applied to estimate the hazard ratio (HR) with a 95% confidence interval (CI) for self-reported CVD on lung cancer incidence rate adjusted for age, sex, body mass index, burden of tobacco smoking and chronic cough with phlegm.


RESULTS
1080 cases of lung cancer (1.1%) occurred. A total of 5981 (6.9%) participants had at baseline or developed during follow-up self-reported CVD. After adjusting for confounders, self-reported CVD was an independent risk factor for the development of lung cancer in former (HR [95% CI] 1.74 [1.11-2.73]) and current smokers (HR [95% CI] 1.38 [1.04-1.83]), but not in never smokers (HR [95% CI] 0.87 [0.34-2.23]).


CONCLUSIONS
Self-reported CVD was independently associated with increased occurrence of lung cancer in former and current smokers. CVD may be a novel risk factor for lung cancer screening.
Department of Thoracic Medicine, St. Olavs Hospital H, TrondheimF; Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim. Electronic address: peter.hatlen@ntnu.no.
Peter
P
Hatlen
HUNT research centre, Deptartment of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Levanger.
Arnulf
A
Langhammer
Department of Endocrinology, St. Olavs Hospital HF, rondheim, Norway; Unit for Applied Clinical Research, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, rondheim, Norway.
Sven Magnus
SM
Carlsen
Unit for Applied Clinical Research, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, rondheim, Norway.
Øyvind
Ø
Salvesen
Department of Thoracic Medicine, St. Olavs Hospital H, TrondheimF; Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim.
Tore
T
Amundsen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D012042:Registries; D012307:Risk Factors; D057566:Self Report; D012907:Smoking / Q000453:epidemiology*; D055815:Young Adult