The Incidence and Risk Analysis of Lung Cancer Development in Patients with Chronic Obstructive Pulmonary Disease: Possible Effectiveness of Annual CT-Screening

• Published in: International journal of chronic obstructive pulmonary disease Vol. 16; pp. 739 - 749
• Main Authors: Machida, Hiroyoshi, Inoue, Sumito, Shibata, Yoko, Kimura, Tomomi, Ota, Takahito, Ishibashi, Yu, Murano, Hiroaki, Furuyama, Kodai, Yang, Sujeong, Nakano, Hiroshi, Sato, Kento, Sato, Masamichi, Nemoto, Takako, Nishiwaki, Michiko, Yamauchi, Keiko, Igarashi, Akira, Watanabe, Masafumi
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2021; Dove Medical Press Ltd; Dove; Dove Medical Press
• Subjects: Asthma; Body mass index; Cancer; Chronic obstructive pulmonary disease; chronic obstructive pulmonary disease (copd); current smoker; Diagnosis; Early Detection of Cancer; Emphysema; Enrollments; gold classification; Health aspects; Humans; Incidence; inhaled corticosteroid (ics); Japan; Lung cancer; Lung diseases, Obstructive; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - epidemiology; Medical research; Medicine, Experimental; Mortality; Original Research; Patients; Pharmaceutical industry; Pulmonary Disease, Chronic Obstructive - diagnostic imaging; Pulmonary Disease, Chronic Obstructive - epidemiology; Risk Assessment; Smoking; Spirometry; Switzerland; Tomography, X-Ray Computed; Switzerland; Japan; lung cancer; current smoker; ICS; GOLD classification; inhaled corticosteroid; COPD; chronic obstructive pulmonary disease
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S287492

Lung cancer is a serious complication in patients with chronic obstructive pulmonary disease (COPD) and accounts for approximately 15% of deaths in patients with COPD. However, with the exception of emphysema, few reports to date have been published on the factors that predict lung cancer development in COPD patients. It has been reported that patients with COPD develop lung cancer at a rate of 0.8% - 1.7%/year, but the incidence may be higher in the Japanese population. Therefore, we investigated the incidence of lung cancer and the lung cancer mortality rate in Japanese COPD patients, as well as factors that are associated with the development of lung cancer in COPD patients. We followed up 224 patients with stable COPD and performed CT examinations at least once per year. The incidence of lung cancer was recorded and data at enrollment were compared with data of the group that did not develop lung cancer. Over a median follow-up period of 4.58 years, lung cancer was newly diagnosed in 19 patients; the incidence of lung cancer in this population was 1.85%/year. Patients who developed lung cancer had more severe emphysema assessed by CT and GOLD classification and were more likely to be current smokers than those who did not develop lung cancer. No other significant differences were observed between these two groups. Mortality was significantly increased in patients who developed lung cancer compared with those who did not. In COPD patients, the incidence of lung cancer is higher and the development of lung cancer worsens the prognosis; however, lung cancer development is unpredictable and attention should be paid to all patients. Annual CT screening is important for early detection of lung cancer.