title: Risk of Lung Cancer Associated with COPD Phenotype Based on Quantitative Image Analysis.
abstract: Chronic obstructive pulmonary disease (COPD) is a risk factor for lung cancer. This study evaluates alternative measures of COPD based on spirometry and quantitative image analysis to better define a phenotype that predicts lung cancer risk.
  
  
  
  A total of 341 lung cancer cases and 752 volunteer controls, ages 21 to 89 years, participated in a structured interview, standardized CT scan, and spirometry. Logistic regression, adjusted for age, race, gender, pack-years, and inspiratory and expiratory total lung volume, was used to estimate the odds of lung cancer associated with FEV1/FVC, percent voxels less than -950 Hounsfield units on the inspiratory scan (HUI) and percent voxels less than -856 HU on expiratory scan (HUE).
  
  
  
  The odds of lung cancer were increased 1.4- to 3.1-fold among those with COPD compared with those without, regardless of assessment method; however, in multivariable modeling, only percent voxels <-856 HUE as a continuous measure of air trapping [OR = 1.04; 95% confidence interval (CI), 1.03-1.06] and FEV1/FVC < 0.70 (OR = 1.71; 95% CI, 1.21-2.41) were independent predictors of lung cancer risk. Nearly 10% of lung cancer cases were negative on all objective measures of COPD.
  
  
  
  Measures of air trapping using quantitative imaging, in addition to FEV1/FVC, can identify individuals at high risk of lung cancer and should be considered as supplementary measures at the time of screening for lung cancer.
  
  
  
  Quantitative measures of air trapping based on imaging provide additional information for the identification of high-risk groups who might benefit the most from lung cancer screening. Cancer Epidemiol Biomarkers Prev; 25(9); 1341-7. ©2016 AACR.
authors.affiliation: Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan. schwarta@karmanos.org.
authors.forename: Ann G
authors.initials: AG
authors.lastname: Schwartz
authors.affiliation: Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Lusk
authors.affiliation: Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Angela S
authors.initials: AS
authors.lastname: Wenzlaff
authors.affiliation: Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Donovan
authors.initials: D
authors.lastname: Watza
authors.affiliation: Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Pandolfi
authors.affiliation: Karmanos Cancer Institute, Detroit, Michigan.
authors.forename: Laura
authors.initials: L
authors.lastname: Mantha
authors.affiliation: Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Michele L
authors.initials: ML
authors.lastname: Cote
authors.affiliation: Karmanos Cancer Institute, Detroit, Michigan. Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Ayman O
authors.initials: AO
authors.lastname: Soubani
authors.affiliation: Department of Radiology, Karmanos Cancer Institute, Detroit, Michigan.
authors.forename: Garrett
authors.initials: G
authors.lastname: Walworth
authors.affiliation: Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Antoinette
authors.initials: A
authors.lastname: Wozniak
authors.affiliation: Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan. Josephine Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan.
authors.forename: Christine
authors.initials: C
authors.lastname: Neslund-Dudas
authors.affiliation: Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan. Josephine Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan.
authors.forename: Amy A
authors.initials: AA
authors.lastname: Ardisana
authors.affiliation: Josephine Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan. Department of Radiology, Henry Ford Health System, Detroit, Michigan.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Flynn
authors.affiliation: Josephine Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan. Department of Radiology, Henry Ford Health System, Detroit, Michigan.
authors.forename: Thomas
authors.initials: T
authors.lastname: Song
authors.affiliation: Josephine Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan. Department of Radiology, Henry Ford Health System, Detroit, Michigan.
authors.forename: David L
authors.initials: DL
authors.lastname: Spizarny
authors.affiliation: Josephine Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan. Department of Pulmonary and Critical Care Medicine, Henry Ford Health System, Detroit, Michigan.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Kvale
authors.affiliation: Josephine Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan. Department of Hematology/Oncology, Henry Ford Health System, Detroit, Michigan.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Chapman
authors.affiliation: Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Shirish M
authors.initials: SM
authors.lastname: Gadgeel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging / Q000453:epidemiology*; D012129:Respiratory Function Tests; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013147:Spirometry; D014057:Tomography, X-Ray Computed; D014797:Vital Capacity