Source: Annual Congress 2009 - Epidemiology and management of lung cancer
Disease area: Airway diseases

Abstract

Background: Lung cancer is the leading cause of cancer deaths. COPD and emphysema have been identified as independent risk factors for lung cancer.
Objective: To determine the prevalence and risk of lung cancer associated with nodules in patients with and without COPD and/or emphysema.
Patients and Methods: 1983 current or former smokers participating in a low dose CT lung cancer screening program underwent CT and spirometry with bronchodilator. The presence of non-calcified nodules and CT evidence of emphysema was confirmed by two experienced radiologists. Those having a postbronchodilator FEV1/FVC < 0.7 and/or emphysema on the CT were classified as having COPD. Four groups of patients were identified for statistical analysis: Group I patients had neither COPD nor nodules, Group II had COPD, but no nodules, Group III had nodules but not COPD, and Group IV had both COPD and nodules. The incidence density of lung cancer in the study groups was determined.
Results:

Table 1

Group	Group	Number of subjects	Number of cancers	Person-years of follow-up	Incidence Density	Risk Ratio	95% CI
COPD	Nodules
No	No	499	1	653	0.0015	Reference
Yes	No	272	3	556	0.0054	3.5	0.3-33.9
No	Yes	679	3	731	0.0041	2.7	0.2-25.9
Yes	Yes	532	25	829	0.0302	19.7	2.7-147.3

Conclusions: In a population of current or former smokers undergoing lung cancer screening, individuals with non-calcified nodules on the CT and COPD, defined as airway obstruction and/or emphysema on the CT, have the highest risk for lung cancer.

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Citations should be made in the following way:
J. P. De Torres, J. P. Wisnivesky, G. Bastarrica, L. Seijo, A. B. Alcaide, A. Campo, A. Villanueva, J. Pueyo, M. D. Lozano, L. Montuenga, J. J. Zulueta (Pamplona, Spain; New York, United States Of America). Lung nodules in a lung cancer screening program: incidence density of lung cancer in patients with COPD and/or emphysema. Eur Respir J 2009; 34: Suppl. 53, 4689

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