Emphysema detected on computed tomography and risk of lung cancer: A systematic review and meta-analysis

Smith, Benjamin M.; Pinto, Lancelot; Ezer, Nicole; Sverzellati, Nicola; Muro, Shigeo; Schwartzman, Kevin

doi:10.1016/j.lungcan.2012.02.019

Cited by 91 publications

(63 citation statements)

References 30 publications

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“…Also, LC+COPD patients had higher pack-years; however, the difference between the groups was not significant in the multivariate analysis. This is in line with the results of other series, with tobacco exposures for both groups around 80–90%, without any significant differences in pack-years in most studies [14, 17, 20, 40]. It is possible that when it comes to heavy smokers with a high amounts of pack-years, additional tobacco exposure may make little difference.…”

Section: Discussionsupporting

confidence: 91%

“…The prevalence of COPD among LC patients is unclear, although it seems to affect at least 28–40% [12-14]. Also, the underdiagnosis of COPD is quite high in most series, including patients with LC, some studies having reported a previous diagnosis of COPD in 7.1% of LC patients [15].…”

Section: Introductionmentioning

confidence: 99%

“…Pulmonary emphysema is the enlargement of airspaces distal to the terminal bronchioles, accompanied by destruction of their walls [14]. Computed tomography-detected emphysema was associated with an increased risk of LC, even for never-smokers [14, 20, 21].…”

Section: Introductionmentioning

confidence: 99%

“…Computed tomography-detected emphysema was associated with an increased risk of LC, even for never-smokers [14, 20, 21]. The diffusing capacity for carbon monoxide (DL CO ) is a surrogate marker of emphysema and correlates well with computed tomography-determined emphysema; however, the degree of association between DL CO and LC development is unclear.…”

Section: Introductionmentioning

confidence: 99%

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Chronic Obstructive Pulmonary Disease in Lung Cancer Patients: Prevalence, Underdiagnosis, and Clinical Characterization

et al. 2018

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Background: Lung cancer (LC) and chronic obstructive pulmonary disease (COPD) are associated with increased morbidity and mortality. The differential clinical and functional features among LC patients with or without COPD have not been defined. Objectives: The aims of this study were to examine the prevalence and underdiagnosis rate of COPD in LC patients and to compare the clinical and functional features of LC patients with and without COPD. Methods: We designed a multicenter hospital-based study including all LC cases diagnosed from January 2014 to August 2016. We assessed epidemiological, clinical, radiological, functional, and histological variables in all cases. Results: We recruited 602 patients with LC, most of them men (77.9%), with a median age of 67 ± 15 years. The COPD prevalence among LC patients was 51.5%, with a underdiagnosis rate of 71.6%. The LC+COPD patients were older and the proportion of men was higher compared with the LC-only patients. The LC+COPD patients had more pack-years, more squamous LC, a lower monoxide transfer coefficient (KCO), and higher Charlson index scores than patients with LC only. The median survival of LC-only patients was 37% longer than that of LC+COPD patients (22 vs. 16 months), but this difference was not statistically significant. Conclusions: Among LC patients, COPD is prevalent and underdiagnosed. Patients with LC+COPD more often have squamous LC, have greater comorbidities, and have a lower KCO. More effort should be made for an early diagnosis of COPD to select patients at higher risk of developing LC.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Chronic Obstructive Pulmonary Disease in Lung Cancer Patients: Prevalence, Underdiagnosis, and Clinical Characterization

et al. 2018

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“…In our population, with a high rate of COPD and a significant risk for cardiovascular disease,37 we believe that reporting these other findings may result in increased attention to existing diseases or risk factors. Radiologist detected emphysema on CT confers an independent increased risk of lung cancer38; detection of emphysema may be useful in refining screening frequency39 and may encourage smoking cessation in these workers.…”

Section: Discussionmentioning

confidence: 99%

Early detection of lung cancer in a population at high risk due to occupation and smoking

Welch

Dement

Cranford³

et al. 2018

Occup Environ Med

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ObjectiveThe US National Comprehensive Cancer Network (NCCN) recommends two pathways for eligibility for Early Lung Cancer Detection (ELCD) programmes. Option 2 includes individuals with occupational exposures to lung carcinogens, in combination with a lesser requirement on smoking. Our objective was to determine if this algorithm resulted in a similar prevalence of lung cancer as has been found using smoking risk alone, and if so to present an approach for lung cancer screening in high-risk worker populations.MethodsWe enrolled 1260 former workers meeting NCCN criteria, with modifications to account for occupational exposures in an ELCD programme.ResultsAt baseline, 1.6% had a lung cancer diagnosed, a rate similar to the National Lung Cancer Screening Trial (NLST). Among NLST participants, 59% were current smokers at the time of baseline scan or had quit smoking fewer than 15 years prior to baseline; all had a minimum of 30 pack-years of smoking. Among our population, only 24.5% were current smokers and 40.1% of our participants had smoked fewer than 30 pack-years; only 43.5% would meet entry criteria for the NLST. The most likely explanation for the high prevalence of screen-detected lung cancers in the face of a reduced risk from smoking is the addition of occupational risk factors for lung cancer.ConclusionOccupational exposures to lung carcinogens should be incorporated into criteria used for ELCD programmes, using the algorithm developed by NCCN or with an individualised risk assessment; current risk assessment tools can be modified to incorporate occupational risk.

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Lung Cancer Susceptibility and Risk Assessment Models

Lin

2014

Lung Cancer

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Emphysema detected on computed tomography and risk of lung cancer: A systematic review and meta-analysis

Cited by 91 publications

References 30 publications

Chronic Obstructive Pulmonary Disease in Lung Cancer Patients: Prevalence, Underdiagnosis, and Clinical Characterization

Chronic Obstructive Pulmonary Disease in Lung Cancer Patients: Prevalence, Underdiagnosis, and Clinical Characterization

Early detection of lung cancer in a population at high risk due to occupation and smoking

Lung Cancer Susceptibility and Risk Assessment Models

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