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Chronic obstructive pulmonary disease and risk of lung cancer: a meta-analysis of prospective cohort studies.

ABSTRACT: Studies exploring the association between chronic obstructive pulmonary disease (COPD) and lung cancer have yielded mixed results. We conducted a meta-analysis of the published prospective cohort studies to have a clear understanding about this association.We searched the MEDLINE and EMBASE databases from inception to December 31, 2016. Bibliographies were also reviewed for additional information. Random-effects model was used to calculate summary relative risk (SRR) and corresponding 95% confidence interval (CI).Eighteen prospective cohort studies were part of this meta-analysis, involving 12,442 lung cancer cases with a median duration of follow- up of 5 years (range: 1.5-20 years). A history of COPD, emphysema or chronic bronchitis conferred SRRs of 2.06 (95% CIs: 1.50-2.85; n=14 studies), 2.33 (95% CIs: 1.56-3.49; n=4 studies) and 1.17 (95%CIs: 0.79-1.73; n=3 studies), respectively. Stratification by COPD severity yielded SRR of 1.46 (95% CIs: 1.20-1.76) for mild, 2.05 (95% CIs: 1.67-2.52) for moderate and 2.44(95% CIs: 1.73-3.45) for severe COPD, respectively. There were similar risk estimations for never and ever smokers. The SRR was statistically higher for squamous cell cancer than that for adenocarcinoma and for small cell cancer of the lung (P<0.05).This meta-analysis indicated a significantly increased risk of lung cancer for COPD, emphysema, but not for chronic bronchitis. For the prevention of lung cancer, it is of importance for early detection of COPD in lung cancer surveillance.

SUBMITTER: Zhang X

PROVIDER: S-EPMC5652835 | biostudies-other | 2017 Sep

REPOSITORIES: biostudies-other

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Chronic obstructive pulmonary disease and risk of lung cancer: a meta-analysis of prospective cohort studies.

Zhang Xinyue X Jiang Ning N Wang Lijuan L Liu Huaman H He Rong R

Oncotarget 20170818 44

<h4>Background</h4>Studies exploring the association between chronic obstructive pulmonary disease (COPD) and lung cancer have yielded mixed results. We conducted a meta-analysis of the published prospective cohort studies to have a clear understanding about this association.<h4>Methods</h4>We searched the MEDLINE and EMBASE databases from inception to December 31, 2016. Bibliographies were also reviewed for additional information. Random-effects model was used to calculate summary relative risk ...[more]

PMID: 29100446

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Project description:BackgroundPatients living with chronic obstructive pulmonary disease (COPD) are at an increased risk of lung cancer. A common comorbidity of COPD is cardiovascular disease; as such, COPD patients often receive statins. This study sought to understand the association between statin exposure and lung cancer risk in a population-based cohort of COPD patients.MethodsWe identified a population-based cohort of COPD patients based on having filled at least three prescriptions for an anticholinergic or short-acting beta-agonist (SABA). We used an array of methods of defining medication exposure including three conventional methods (ever statin exposure, cumulative duration of use, and cumulative dose) and two novel methods (recency-weighted cumulative duration of use and recency-weighted cumulative dose). To assess residual confounding, a negative control exposure was used to test the validity of our results. All exposure variables were time-dependent.ResultsThe population-based cohort of COPD had 39,879 patients with mean age of 70.6 (SD: 11.2) years and, of which, 53.5% were female. There were 12,469 patients who received at least one statin prescription. Results from the reference case multivariable analysis indicated a reduced risk from statin exposure (HR: 0.85 (95% CI: 0.73-1.00) in COPD patients, but this result not statistically significant. Using the two recency-weighted modelling approaches, statin exposure was associated with a statistically significant reduction in lung cancer risk (recency-weighted cumulative dose, HR: 0.85 (95% CI: 0.77-0.93) and recency-weighted cumulative duration of use, HR: 0.97 (95% CI: 0.96-0.99). Multivariable analysis incorporating the negative control exposure was not statistically significant (HR: 0.89 (95% CI: 0.75-1.10).ConclusionsThe results of this population-based analysis indicate that statin use in COPD patients may reduce the risk of lung cancer. While the effect was not statistically significantly across all exposure definitions, the overall results support the hypothesis that COPD patients might benefit from statin therapy.

Dataset Information

Chronic obstructive pulmonary disease and risk of lung cancer: a meta-analysis of prospective cohort studies.

Publications

Chronic obstructive pulmonary disease and risk of lung cancer: a meta-analysis of prospective cohort studies.

Similar Datasets

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