Cancer development in patients with COPD: a retrospective analysis of the National Health Insurance Service-National Sample Cohort in Korea

• Published in: BMC pulmonary medicine Vol. 20; no. 1; pp. 170 - 10
• Main Authors: Ahn, Song Vogue, Lee, Eunyoung, Park, Bumhee, Jung, Jin Hee, Park, Ji Eun, Sheen, Seung Soo, Park, Kwang Joo, Hwang, Sung Chul, Park, Jae Bum, Park, Hae-Sim, Park, Joo Hun
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 15.06.2020; BioMed Central; BMC
• Subjects: Adult; Age; Aged; Bladder cancer; Body mass index; Cancer; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; Colorectal cancer; Colorectal carcinoma; Complications and side effects; COPD; Development and progression; Diabetes; Diabetes mellitus; Environmental factors; Esophageal cancer; Female; Gastric cancer; Health insurance; Health risk assessment; Humans; Hypertension; Kidney cancer; Liver cancer; Lung cancer; Lung Neoplasms - epidemiology; Male; Males; Medical diagnosis; Medical screening; Middle Aged; National Health Programs; Population; Proportional Hazards Models; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonology; Questionnaires; Regression analysis; Republic of Korea - epidemiology; Retrospective Studies; Risk Factors; Smoking; Smoking - adverse effects; Studies; Variables; Republic of Korea; South Korea; COPD; Cancer; Smoking
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-020-01194-8

COPD is a well-known risk factor for lung cancer, independent of smoking behavior. By investigating the retrospective National Health Insurance Service-National Sample Cohort (NHIS-NSC) in Korea, this study attempted to prove the hypothesis that COPD is a risk factor for major cancers developing outside of the lungs. We also aimed to investigate the environmental factors associated with the development of lung cancer in COPD patients. This study analyzed data from the NHIS-NSC over a 12-year period. Among the 514,795 subjects in the NHIS-NSC, 16,757 patients who were diagnosed with any cancer from 2002 to 2003 were excluded. This cohort enrolled six arms consisting of never-smokers without COPD (N = 313,553), former smokers without COPD (N = 41,359), smokers without COPD (N = 112,627), never-smokers with COPD (N = 7789), former smokers with COPD (N = 1085), and smokers with COPD (N = 2677). Incident rate of lung cancer per 100,000 person-year was higher according to smoking and COPD (216 in non-COPD and 757 in COPD among never-smokers, 271 in non-COPD and 1266 in COPD among former smokers, 394 in non-COPD and 1560 in COPD among smokers, p <  0.01). Old age, male sex, lower BMI, low exercise level, history of diabetes mellitus, smoking, and COPD were independent factors associated with the development of lung cancer (p <  0.01). Multi-variable analyses showed that COPD, regardless of smoking status, contributed to the development of lung cancer, and colorectal cancer and liver cancer among other major cancers (p <  0.01). Our data suggested that COPD was an independent risk factor for the development of lung cancer, and colorectal cancer and liver cancer among other major cancers in the Korean population, regardless of smoking status.