title: The coexistence of common pulmonary diseases on the histologic type of lung cancer in both genders in Taiwan: a STROBE-compliant article.
abstract: Effects of pulmonary diseases [asthma, chronic obstructive pulmonary disease (COPD), and lung tuberculosis (TB)] on subsequent lung cancer development have been reported. However, whether patients with coexisting pulmonary diseases are at greater risk of developing various histologic types of lung cancer remains elusive. Patients newly diagnosed with lung cancer between 2004 and 2008 were identified from National Health Insurance Research Database (Taiwan). The histologic types of lung cancer were further confirmed using Taiwan Cancer Registry Database. Cox proportional hazard regression was used to calculate the hazard ratio (HR) of coexisting asthma, COPD and/or TB to estimate lung cancer risk by histologic type. During the study period, 32,759 cases of lung cancer were identified from 15,219,024 residents age 20 years and older, who were free from the disease before 2003. Coexisting pulmonary diseases showed stronger association with lung cancer than specific lung disorders. Specifically, among men, the HRs for squamous cell carcinoma (SqCC) were 3.98 (95% CI, 3.22-4.93), 2.68 (95% CI, 2.45-2.93), and 2.57 (95% CI, 2.10-3.13) for individuals with asthma+COPD+TB, asthma+COPD, and COPD+TB, respectively. Among women, the HRs for SqCC were 3.64 (95% CI, 1.88-7.05), 3.35 (95% CI, 1.59-7.07), and 2.21 (95% CI, 1.66-2.94) for individuals with TB, COPD+TB, and asthma+COPD, respectively. Adenocarcinoma HRs for men and women were 2.00 (95% CI, 1.54-2.60) and 2.82 (95% CI, 1.97-4.04) for individuals with asthma+COPD+TB, 2.28 (95% CI, 1.91-2.73) and 2.16 (95% CI, 1.57-2.95) for COPD+TB, and 1.76 (95% CI, 1.04-2.97) and 2.04 (95% CI, 1.02-4.09) for individuals with asthma+TB. Specifically, small cell carcinoma (SmCC) HRs among men were 3.65 (95% CI, 1.97-6.80), 2.20 (95% CI, 1.45-3.36), and 2.14 (95% CI, 1.86-2.47) for those with asthma+TB, asthma+COPD+TB, and asthma+ COPD, respectively. Among women, the HRs of SmCC were 8.97 (95% CI, 3.31-24.28), 3.94 (95% CI, 1.25-12.35) and 3.33 (95% CI, 2.23-4.97) for those with asthma+COPD+TB, COPD+TB, and asthma+COPD, respectively. Patients with coexistence of pulmonary diseases were more susceptible to lung cancer. Affected persons deserve greater attention while undergoing cancer screening.
authors.affiliation: From the Department of Public Health and Institute of Public Health (ZHJ, CCL, JYH, PCK, SRJ, ONN, WYK, YPL); Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung City (CCL, YPL); Department of Physical Education (CCH), Fu Jen Catholic University, New Taipei City, Taiwan; Department of Pediatrics (HHP); and School of Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan (HHP).
authors.forename: Zhi-Hong
authors.initials: ZH
authors.lastname: Jian
authors.forename: Chia-Chi
authors.initials: CC
authors.lastname: Lung
authors.forename: Jing-Yang
authors.initials: JY
authors.lastname: Huang
authors.forename: Pei-Chieh
authors.initials: PC
authors.lastname: Ko
authors.forename: Shiou-Rung
authors.initials: SR
authors.lastname: Jan
authors.forename: Oswald
authors.initials: O
authors.lastname: Ndi Nfor
authors.forename: Wen-Yuan
authors.initials: WY
authors.lastname: Ku
authors.forename: Chien-Chang
authors.initials: CC
authors.lastname: Ho
authors.forename: Hui-Hsien
authors.initials: HH
authors.lastname: Pan
authors.forename: Yung-Po
authors.initials: YP
authors.lastname: Liaw
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000150:complications; D002277:Carcinoma / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D013624:Taiwan / Q000453:epidemiology; D014376:Tuberculosis / Q000150:complications; D055815:Young Adult