title: Pre-existing Pulmonary Diseases and Survival in Patients With Stage-dependent Lung Adenocarcinoma: A STROBE-compliant Article.
abstract: Asthma, chronic obstructive pulmonary disease (COPD), and pulmonary tuberculosis (TB) are common lung diseases associated with lung cancer mortality. This study evaluated sex disparities in pre-existing pulmonary diseases and stage-dependent lung adenocarcinoma survival.Patients newly diagnosed with lung adenocarcinoma between 2003 and 2008 were identified using the National Health Insurance Research Database and Cancer Registry. Cases with lung adenocarcinoma were followed until the end of 2010. Survival curves were estimated by the Kaplan-Meier method. Cox proportional-hazard regression was used to calculate the hazard ratio (HR) of pre-existing asthma, COPD, and/or TB, and to estimate all-cause mortality risk in patients with different stages of lung adenocarcinoma.A total of 14,518 cases were identified with lung adenocarcinoma. Specifically, among men, the HRs for TB were 1.69 (95% confidence interval [CI], 1.10-2.58), 1.48 (95% CI, 1.14-1.93), and 1.27 (95% CI, 1.08-1.49) for individuals with stage I + II, III, and IV diseases, respectively. The HRs for asthma were 1.41 (95% CI, 1.00-1.99) in women with stage I + II and 1.14 (95% CI, 1.04-1.26) in men with stage IV disease. For pulmonary disease combinations in men, the HRs were 1.45 (95% CI, 1.12-1.89) for asthma + COPD + TB, 1.35 (95% CI, 1.12-1.63) for COPD + TB, 1.28 (95% CI, 1.01-1.63) for TB, and 1.15 (95%CI, 1.04-1.27) for asthma + COPD, respectively. For women with stage I + II disease, the HR was 6.94 (95% CI, 2.72-17.71) for asthma + COPD + TB.Coexistence of pre-existing pulmonary diseases increased mortality risk in men with adenocarcinoma. TB is at elevated risk of mortality among men with different stages of adenocarcinoma. Asthmatic women with early-stage adenocarcinoma had increased risk of mortality.
authors.affiliation: From the Department of Public Health and Institute of Public Health (Z-HJ, J-YH, ONN, K-MJ, W-YK, C-CL, Y-PL); School of Medicine, Chung Shan Medical University (H-HP, M-FW); Department of Family and Community Medicine (C-CL, Y-PL); Department of Pediatrics (H-HP); Divisions of Medical Oncology and Pulmonary Medicine, Chung Shan Medical University Hospital, Taichung City (M-FW); Department of Neurology, Changhua Christian Hospital, Changhua (K-MJ); Department of Physical Education, Fu Jen Catholic University, New Taipei City (C-CH); and College of Humanities and Social Sciences and Taipei Medical University (Y-CL), Taipei City, Taiwan.
authors.forename: Zhi-Hong
authors.initials: ZH
authors.lastname: Jian
authors.forename: Jing-Yang
authors.initials: JY
authors.lastname: Huang
authors.forename: Oswald Ndi
authors.initials: ON
authors.lastname: Nfor
authors.forename: Kai-Ming
authors.initials: KM
authors.lastname: Jhang
authors.forename: Wen-Yuan
authors.initials: WY
authors.lastname: Ku
authors.forename: Chien-Chang
authors.initials: CC
authors.lastname: Ho
authors.forename: Chia-Chi
authors.initials: CC
authors.lastname: Lung
authors.forename: Hui-Hsien
authors.initials: HH
authors.lastname: Pan
authors.forename: Yu-Chiu
authors.initials: YC
authors.lastname: Liang
authors.forename: Ming-Fang
authors.initials: MF
authors.lastname: Wu
authors.forename: Yung-Po
authors.initials: YP
authors.lastname: Liaw
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000401:mortality*; D001249:Asthma / Q000150:complications; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D013624:Taiwan / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000150:complications