title: The Impact of Coexisting Asthma, Chronic Obstructive Pulmonary Disease and Tuberculosis on Survival in Patients with Lung Squamous Cell Carcinoma.
abstract: BACKGROUND
  Pulmonary diseases [asthma, chronic obstructive pulmonary disease (COPD), and tuberculosis (TB)] are associated with lung cancer mortality. However, the relationship between coexisting pulmonary diseases and survival in patients with lung squamous cell carcinoma (SqCC) has not been well defined.
  
  
  METHODS
  Patients newly diagnosed with SqCC between 2003 and 2008 were identified by linking the National Health Insurance Research Database and Taiwan Cancer Registry Database. Cases with SqCC were followed up until death, loss to follow-up, or study end in 2010. Information on health status, date of death and the main causes of death was ascertained from the National Death Registry Database. Cox proportional hazard regression was used to calculate the hazard ratio (HR) of coexisting asthma, COPD and/or TB.
  
  
  RESULTS
  During the study period, a total of 5406 cases with SqCC were enrolled. For all cause-mortality, HRs were 1.08 [95% confidence interval (CI), 0.99-1.18], 1.04 (95% CI, 0.97-1.12), and 1.14 (95% CI, 1.00-1.31) for individuals with asthma, COPD, and TB, respectively. Specifically, among men with coexisting pulmonary diseases, the HRs were 1.56 (95% CI, 1.23-1.97) and 1.11 (95% CI, 1.00-1.24) for individuals with asthma+COPD+TB and asthma+COPD, respectively. Among male patients with stage III SqCC, HRs were 3.41 (95%CI, 1.27-9.17) and 1.65 (95%CI, 1.10-2.47) for individuals with asthma+TB and asthma+COPD+TB, respectively. Among male patients with stage IV SqCC, HRs were 1.40 (95%CI, 1.00-1.97) and 1.25 (95%CI, 1.03-1.52) for individuals with asthma+ COPD+TB and asthma. Among female patients with stage I and II, HR was 0.19 (95%CI, 005-0.77) for individuals with asthma.
  
  
  CONCLUSIONS
  Coexisting pulmonary diseases increased the risk of mortality from SqCC in male patients. For female patients with early stage SqCC, pre-existing asthma decreased mortality. These patients deserve greater attention while undergoing cancer treatment.
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan.
authors.forename: Jing-Yang
authors.initials: JY
authors.lastname: Huang
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan.
authors.forename: Zhi-Hong
authors.initials: ZH
authors.lastname: Jian
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan.
authors.forename: Oswald
authors.initials: O
authors.lastname: Ndi Nfor
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan; Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Kai-Ming
authors.initials: KM
authors.lastname: Jhang
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan.
authors.forename: Wen-Yuan
authors.initials: WY
authors.lastname: Ku
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan.
authors.forename: Pei-Chieh
authors.initials: PC
authors.lastname: Ko
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan.
authors.forename: Shiou-Rung
authors.initials: SR
authors.lastname: Jan
authors.affiliation: Department of Physical Education, Fu Jen Catholic University, New Taipei City, Taiwan.
authors.forename: Chien-Chang
authors.initials: CC
authors.lastname: Ho
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan; Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan.
authors.forename: Chia-Chi
authors.initials: CC
authors.lastname: Lung
authors.affiliation: Department of Pediatrics, Chung Shan Medical University Hospital, Taichung City, Taiwan; School of Medicine, Chung Shan Medical University, Taichung City, Taiwan.
authors.forename: Hui-Hsien
authors.initials: HH
authors.lastname: Pan
authors.affiliation: College of Humanities and Social Sciences, Taipei Medical University, Taipei City, Taiwan.
authors.forename: Yu-Chiu
authors.initials: YC
authors.lastname: Liang
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan; Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan.
authors.forename: Yung-Po
authors.initials: YP
authors.lastname: Liaw
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000453:epidemiology*; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology* / Q000401:mortality; D015897:Comorbidity; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D012042:Registries / Q000706:statistics & numerical data; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*