Mortality of adults with asthma: a prospective cohort study

Abstract

Some of the inconsistency may have arisen from confounding since, although many studies Background -Few studies have been published on the overall survival of adult have controlled for the effect of age, sex and smoking, 2 5 15 the effects of occupation 15 and patients with asthma. A cohort study was performed to assess the mortality from all other lung diseases 2 may also be important. We have studied mortality from all causes among causes, from chronic obstructive pulmonary disease, and from lung cancer persons with asthma in Finland in a population based cohort study, in addition to the specific among adult asthmatic subjects. Methods -A population of 31 110 Finnish risk of death due to asthma, chronic obstructive pulmonary disease, and lung cancer. Possible adult women and men, mostly twins, was studied to compare the 16 year mortality confounding due to smoking, social class, domestic animals and pets, other respiratory morrates among asthmatic (n=471) and nonasthmatic persons. A further 293 twin bidity, and atopy have been taken into account. pairs, discordant for asthma, were also studied to determine whether the mortality of patients with asthma differs from Methods that of their age matched siblings.  Results -Mortality from all causes was The study population was based on the Finnish increased among asthmatic adults (age twin cohort which consists primarily of adult adjusted hazard ratios 1.49, 95% CI 1.09 twin pairs, with both members alive in 1967 to 2.05 for men and 1.53, 95% CI 1.10 and born before 1958, as well as some unrelated to 2.13 for women), and mortality due to individuals included because of the selection chronic obstructive pulmonary diseases criteria used to form the cohort. 16 Pairs of was also significantly increased in asth-persons with the same date of birth, same matic subjects. The risk of death due to surname at birth, same local community of lung cancer was increased in men with birth, and same sex were identified from the asthma (hazard ratio adjusted for smoking Central Population Registry of Finland. A 3.19, 95% CI 1.39 to 7.31). The risk ratios postal questionnaire was mailed in the autumn found among twins discordant for asthma of 1975 with questions that covered twinship, corresponded to those found in the whole medical history, symptoms, state of health, socohort.cial factors, and psychological traits. The reConclusions -Survival in adults with sponse rate of the questionnaire study was 89%, asthma is worse than in those without yielding 31 110 responses, 26 533 from twins asthma. The excess deaths due to chronic and 4577 from singletons. Twinship was deobstructive pulmonary disease may ex-termined from questionnaire responses and plain some part of the increased mortality confirmed, when necessary, from birth records rates, but not all of it.in local parish registers. Zygosity was de- (Thorax 1997;52:49-54) termined by a validated questionnaire method. 17 Department of Public Health, FIN-00014Keywords: asthma, mortality, cohort study. The medic...

Long-term mortality among adults with or without asthma in the PAARC study

“…They also stressed the role of an FEV1 ofv80% pred as a predictor of mortality, but its role was similar in asthmatics and nonasthmatics. The mortality rate from all causes in the present study is comparable to those reported in previous studies; MARKOWE et al [8] found increased mortality from all causes (RR 1.6, 95% CI 1.3-2.0) and HUOVINEN et al [30] found an age-adjusted RR of 1.5 (95% CI 1.1-2.1).…”

“…This finding supports the hypotheses of previous studies, according to which asthma is a risk factor for COPD and COPD a risk factor for mortality in asthma [29]. No significant excess in mortality from lung cancer was found among asthmatics, unlike in the studies of BOFFETTA et al [6], HUOVINEN et al [30] and WU et al [31], in which the risk of death due to lung cancer adjusted for smoking was higher in males with asthma (RR 3.2, 95% CI 1.4-7.3). However, no long-term survival studies controlled for occupational exposure.…”

Cancer risk in hospitalised asthma patients

“…The increased risk for lung cancer was noted in many earlier studies (Vesterinen et al, 1993;Huovinen et al, 1997;Mayne et al, 1999;Boffett et al, 2002). Smoking is a common risk factor for lung cancer and asthma (Silverman et al, 2003;Eisner, 2008).…”

Aspirin and lung cancer in women

“…Several studies have found that inflammatory lung diseases, including asthma and chronic bronchitis are associated with increased incidence of lung cancer (Alavanja et al, 1992;Kallen et al, 1993;Vesterinen et al, 1993;Wu et al, 1995;Huovinen et al, 1997;Mayne et al, 1999;Brownson and Alavanja, 2000;Brenner et al, 2001).…”