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

• Main Authors: Machida H, Inoue S, Shibata Y, Kimura T, Ota T, Ishibashi Y, Murano H, Furuyama K, Yang S, Nakano H, Sato K, Sato M, Nemoto T, Nishiwaki M, Yamauchi K, Igarashi A, Watanabe M
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-03-01
• Series: International Journal of COPD
• Subjects: chronic obstructive pulmonary disease (copd); lung cancer; gold classification; current smoker; inhaled corticosteroid (ics)
• Online Access: https://www.dovepress.com/the-incidence-and-risk-analysis-of-lung-cancer-development-in-patients-peer-reviewed-article-COPD

Hiroyoshi Machida,1 Sumito Inoue,1 Yoko Shibata,2 Tomomi Kimura,3 Takahito Ota,1 Yu Ishibashi,1 Hiroaki Murano,1 Kodai Furuyama,1 Sujeong Yang,1 Hiroshi Nakano,1 Kento Sato,1 Masamichi Sato,1 Takako Nemoto,1 Michiko Nishiwaki,1 Keiko Yamauchi,1 Akira Igarashi,1 Masafumi Watanabe1 1Department of Cardiology, Pulmonology, and Nephrology, Yamagata University Faculty of Medicine, Yamagata, Japan; 2Department of Pulmonary Medicine, Fukushima Medical University, Fukushima, Japan; 3Respiratory Medicine, Yamagata Saisei Hospital, Yamagata, JapanCorrespondence: Sumito InoueDepartment of Cardiology, Pulmonology, and Nephrology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, JapanEmail [e-mail]: 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.Patients and Methods: 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.Results: 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.Conclusion: 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.Keywords: chronic obstructive pulmonary disease, COPD, lung cancer, GOLD classification, current smoker, inhaled corticosteroid, ICS