title: The effects of pulmonary diseases on histologic types of lung cancer in both sexes: a population-based study in Taiwan.
abstract: BACKGROUND
  The associations between pulmonary diseases (asthma, chronic obstructive pulmonary disease [COPD], and tuberculosis [TB]) and subsequent lung cancer risk have been reported, but few studies have investigated the association with different histologic types of lung cancer.
  
  
  METHODS
  Patients newly diagnosed with lung cancer from 2004 to 2008 were identified from the National Health Insurance Research Database in Taiwan. Histologic types of lung cancer were further confirmed using the Taiwan Cancer Registry Database. Cox proportional hazards regression was used to calculate the hazard ratio (HR) of asthma, COPD, and TB and to estimate the risk of specific types of lung cancer.
  
  
  RESULTS
  During the study period, 32,759 cases of lung cancer were identified from 15,219,024 insurants aged 20 years and older. In men and women, the adjusted HR estimates of squamous cell carcinoma were respectively 1.37 (95 % confidence interval [CI], 1.21-1.54) and 2.10 (95 % CI, 1.36-3.23) for TB, 1.52 (95 % CI, 1.42-1.64) and 1.50 (95 % CI, 1.21-1.85) for asthma, and 1.66 (95 % CI, 1.56-1.76) and 1.44 (95 % CI, 1.19-1.74) for COPD. Similarly, the adjusted HR estimates of adenocarcinoma were respectively 1.33 (95 % CI, 1.19-1.50) and 1.86 (95 % CI, 1.57-2.19) for TB, 1.13 (95 % CI, 1.05-1.21) and 1.18 (95 % CI, 1.09-1.28) for asthma, and 1.50 (95 % CI, 1.42-1.59) and 1.33 (95 % CI, 1.25-1.42) for COPD. The HRs of small cell carcinoma were respectively 1.24 (95 % CI, 1.01-1.52) and 2.23 (95 % CI, 1.17-4.25) for TB, 1.51 (95 % CI, 1.35-1.69) and 1.63 (95 % CI, 1.16-2.27) for asthma, and 1.39 (95 % CI, 1.26-1.53) and 1.78 (95 % CI, 1.33-2.39) for COPD.
  
  
  CONCLUSIONS
  Asthma, COPD, and TB were associated with an increased risk of all major subtypes of lung cancer. The risk was the highest among women with TB.
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110, Sec. 1 Jianguo N. Rd., Taichung City, 40201, Taiwan. wchinyang@yahoo.com.tw.
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, No. 110, Sec. 1 Jianguo N. Rd., Taichung City, 40201, Taiwan. s841039@yahoo.com.tw.
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, No. 110, Sec. 1 Jianguo N. Rd., Taichung City, 40201, Taiwan. nforoswald2@yahoo.com.
authors.forename: Oswald Ndi
authors.initials: ON
authors.lastname: Nfor
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110, Sec. 1 Jianguo N. Rd., Taichung City, 40201, Taiwan. yuan3156@gmail.com.
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, No. 110, Sec. 1 Jianguo N. Rd., Taichung City, 40201, Taiwan. ko52070@hotmail.com.
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, No. 110, Sec. 1 Jianguo N. Rd., Taichung City, 40201, Taiwan. dinoljc@csmu.edu.tw.|Department of Family and Community Medicine, Chung Shan Medical University Hospital, 40201, Taichung City, Taiwan. dinoljc@csmu.edu.tw.
authors.forename: Chia-Chi
authors.initials: CC
authors.lastname: Lung
authors.affiliation: Department of Physical Education, Fu Jen Catholic University, New Taipei City, Taiwan. ccho1980@gmail.com.
authors.forename: Chien-Chang
authors.initials: CC
authors.lastname: Ho
authors.affiliation: School of Medicine, Chung Shan Medical University, Taichung City, Taiwan. jsee06@yahoo.com.tw.|Department of Pediatrics, Chung Shan Medical University Hospital, Taichung City, Taiwan. jsee06@yahoo.com.tw.
authors.forename: Hui-Hsien
authors.initials: HH
authors.lastname: Pan
authors.affiliation: Department of Chemical Technology, Songshan High School of Agriculture and Industry, Taipei City, Taiwan. chiehying@saihs.edu.tw.
authors.forename: Chieh-Ying
authors.initials: CY
authors.lastname: Huang
authors.affiliation: College of Humanities and Social Sciences, Taipei Medical University, Taipei City, Taiwan. nicole0868@yahoo.com.tw.
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, No. 110, Sec. 1 Jianguo N. Rd., Taichung City, 40201, Taiwan. Liawyp@csmu.edu.tw.|Department of Family and Community Medicine, Chung Shan Medical University Hospital, 40201, Taichung City, Taiwan. Liawyp@csmu.edu.tw.
authors.forename: Yung-Po
authors.initials: YP
authors.lastname: Liaw
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000473:pathology; D012307:Risk Factors; D012727:Sex Characteristics; D013624:Taiwan / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology* / Q000473:pathology