Abstract
Lung cancer is one of the primary causes of death with poor life expectancy after diagnosis. History of past respiratory diseases such as asthma, chronic obstructive lung disease (COPD), emphysema, and chronic bronchitis can increase the risk of lung cancer. Very few studies are available to simultaneously assess multiple respiratory diseases and lung cancer. The objective of this study was to investigate correlations between asthma, emphysema, chronic bronchitis, and chronic obstructive lung disease with lung cancer in the US adult population. This was a cross-sectional study using data from a total of 23,523 adult participants from the National Health Examination and Nutrition Survey (NHANES) datasets for seven cycles ranging from 2003–2004 to 2015–2016. To analyze the data, specialized weighted complex survey logit regressions were conducted. Linear logit regression models using only main-effects were constructed first to assess the correlation between the selected demographic and lifestyle variables and asthma, emphysema, chronic bronchitis, and COPD. A second set of linear, main-effects logit regression models were constructed to examine the correlation between lung cancer and asthma, emphysema, chronic bronchitis, COPD when corrected for the selected covariates. The study identified positive correlations between emphysema, chronic bronchitis, COPD, and lung cancer. No correlation between asthma and lung cancer was established. Of the covariates studied, race/ethnicity, marital status, highest educational level, age, family income to poverty ratio, and lifetime smoking were also found to be correlated with the presence of lung cancer. Correlations between the covariates gender, body mass index, alcohol consumption, and country of birth and lung cancer were not found. The study established statistically significant correlations between lung cancer and the lung diseases emphysema, chronic bronchitis, and COPD. The lack of association between asthma and lung cancer may arise from the timeline of diagnosis asthma or type of lung cancer. The study also established significant correlations between lung cancer and several of the covariates included in the analysis. It also established correlations between the covariates and the lung diseases asthma, emphysema, chronic bronchitis, and COPD.
Similar content being viewed by others
Data availability
The datasets supporting the conclusions of this article are available in the NHANES repository, at https://www.cdc.gov/nchs/nhanes/index.htm.
References
American Thoracic Society (1995) Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease. American Thoracic Society. Am J Respir Crit Care Med 152(5 Pt 2):S77–S121
Barnes PJ, Adcock IM (2011) Chronic obstructive pulmonary disease and lung cancer: a lethal association. Am J Respir Crit Care Med 184(8):866–867. https://doi.org/10.1164/rccm.201108-1436ED
Boffetta P, Ye W, Boman G, Nyrén (2002) Lung cancer risk in a population-based cohort of patients hospitalized for asthma in Sweden. Eur Respir J 19(1):127–133. https://doi.org/10.1183/09031936.02.00245802
Brenner DR, Boffetta P, Duell EJ et al (2012) Previous lung diseases and lung cancer risk: a pooled analysis from the International Lung Cancer Consortium. Am J Epidemiol 176(7):573–585. https://doi.org/10.1093/aje/kws151
Brown DW, Young KE, Anda RF, Giles WH (2005) Asthma and risk of death from lung cancer: NHANES II Mortality Study. J Asthma 42(7):597–600. https://doi.org/10.1080/02770900500216234
CDC (2017a) Body Measures (BMX_I). National Center for Health Statistics. https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/BMX_I.htm. Accessed 4 April 2022
CDC (2017b) Demographic variables and sample weights (DEMO_I). National Center for Health Statistics. https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/DEMO_I.htm. Accessed 4 April 2022
CDC (2017c) Medical Conditions (MCQ_I). National Center for Health Statistics. https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/MCQ_I.htm. Accessed 4 April 2022
CDC (2017d) Smoking - Cigarette Use (SMQ_I). National Center for Health Statistics. https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/SMQ_I.htm. Assessed 4 April 2022
CDC (2018) Alcohol Use (ALQ_I). National Center for Health Statistics. https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/ALQ_I.htm. Accessed 4 April 2022
CDC (2019) Cotinine and hydroxycotinine-serum (COT_I). National Center for Health Statistics. https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/COT_I.htm. Assessed 4 April 2022
de Groot PM, Wu CC, Carter BW, Munden RF (2018) The epidemiology of lung cancer. Transl Lung Cancer Res 7(3):220–233. https://doi.org/10.21037/tlcr.2018.05.06
Denholm R, Schüz J, Straif K et al (2014) Is previous respiratory disease a risk factor for lung cancer? Am J Respir Crit Care Med 190(5):549–559. https://doi.org/10.1164/rccm.201402-0338OC
Durham AL, Adcock IM (2015) The relationship between COPD and lung cancer. Lung Cancer 90(2):121–127. https://doi.org/10.1016/j.lungcan.2015.08.017
[GINA] Global Initiative for Asthma (2015) Global strategy for asthma management and prevention. https://ginasthma.org/wp-content/uploads/2016/01/GINA_Report_2015_Aug11-1.pdf. Accessed 17 January 2022
[GOLD] Global Initiative for Chronic Obstructive Lung Disease (2015) Diagnosis of diseases of chronic airflow limitation: asthma COPD and asthma-COPD overlap syndrome (ACOS). https://goldcopd.org/wp-content/uploads/2016/04/GOLD_ACOS_2015.pdf. Accessed 17 January 2022
[GOLD] Global Initiative for Chronic Obstructive Lung Disease (2020) Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease 2021 Report. https://goldcopd.org/wp-content/uploads/2020/11/GOLD-REPORT-2021-v1.1-25Nov20_WMV.pdf. Accessed 17 January 2022
Goodridge D, Lawson J, Duggleby W, Marciniuk D, Rennie D, Stang M (2008) Health care utilization of patients with chronic obstructive pulmonary disease and lung cancer in the last 12 months of life. Respir Med 102(6):885–891. https://doi.org/10.1016/j.rmed.2008.01.007
Howlader N, Noone AM, Krapcho M, et al (2018) SEER Cancer Statistics Review, 1975–2014, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2014/. Accessed 17 January 2022
Lumley T (2004) Analysis of complex survey samples. J Stat Softw 9(1):1–19
Lumley TS (2010) Complex surveys: a guide to analysis using R. John Wiley & Sons, Hoboken
Lumley TS (2020) “survey: analysis of complex survey samples,” version 4.0. https://cran.rproject.org/web/packages/survey/survey.pdf. Accessed 25 Nov 2021
[NCHS] National Center for Health Statistics (2017) About the National Health and Nutrition Examination Survey. CDC. https://www.cdc.gov/nchs/nhanes/about_nhanes.htm. Accessed 4 April 2022
Papi A, Casoni G, Caramori G et al (2004) COPD increases the risk of squamous histological subtype in smokers who develop non-small cell lung carcinoma. Thorax 59(8):679–681. https://doi.org/10.1136/thx.2003.018291
Putila J, Guo NL (2014) Combining COPD with clinical, pathological and demographic information refines prognosis and treatment response prediction of non-small cell lung cancer. PLoS One 9(6):e100994. https://doi.org/10.1371/journal.pone.0100994
Rahman HH, Yusuf KK, Niemann D, Dipon SR (2020) Urinary speciated arsenic and depression among US adults. Environ Sci Pollut Res Int 27(18):23048–23053. https://doi.org/10.1007/s11356-020-08858-2
Rahman HH, Niemann D, Munson-McGee SH (2022a) Association between environmental toxic metals, arsenic and polycyclic aromatic hydrocarbons and chronic obstructive pulmonary disease in the US adult population. Environ Sci Pollut Res Int 29(36):54507–54517. https://doi.org/10.1007/s11356-022-19695-w
Rahman HH, Niemann D, Munson-McGee SH (2022b) Urinary metals, arsenic, and polycyclic aromatic hydrocarbon exposure and risk of self-reported emphysema in the US adult population. Lung 200(2):237–249. https://doi.org/10.1007/s00408-022-00518-1
Rahman HH, Niemann D, Munson-McGee SH (2022c) Urinary polycyclic aromatic hydrocarbon, arsenic, and metal exposure and correlation with emphysema in smokers. Toxicol Appl Pharmacol 450:116168. https://doi.org/10.1016/j.taap.2022.116168
Rahman HH, Niemann D, Munson-McGee SH (2022e) Association among urinary polycyclic aromatic hydrocarbons and depression: a cross-sectional study from NHANES 2015–2016. Environ sci Pollut Res Int 29(9):13089–13097
Rahman HH, Niemann D, Munson-McGee SH (2022f) Association of albumin to creatinine ratio with urinary arsenic and metal exposure: evidence from NHANES 2015–2016. Int Urol Nephrol 54(6):1343–1353. https://doi.org/10.1007/s11255-021-03018-y
Rahman HH, Niemann D, Munson-McGee SH (2022g) Association of chronic kidney disease with exposure to polycyclic aromatic hydrocarbons in the US population. Environ Sci Pollut Res Int 29(16):24024–24034. https://doi.org/10.1007/s11356-021-17479-2
Rahman HH, Niemann D, Munson-McGee SH (2022d) Urinary metals, arsenic, and polycyclic aromatic hydrocarbon exposure and risk of chronic bronchitis in the US adult population. Environmental science and pollution research international. Advance online publicationhttps://doi.org/10.1007/s11356-022-20982-9
Riseberg E, Melamed RD, James KA, Alderete TL, Corlin L (2021) Development and application of an evidence-based directed acyclic graph to evaluate the associations between metal mixtures and cardiometabolic outcomes, medRxiv 2021.03.05.21252993 https://doi.org/10.1101/2021.03.05.21252993.
Rosenberger A, Bickeböller H, McCormack V et al (2012) Asthma and lung cancer risk: a systematic investigation by the International Lung Cancer Consortium. Carcinogenesis 33(3):587–597. https://doi.org/10.1093/carcin/bgr307
Santillan AA, Camargo CA Jr, Colditz GS (2003) A meta-analysis of asthma and risk of lung cancer (United States). Cancer Causes Control. 14(4):327–334. https://doi.org/10.1023/a:1023982402137
Seijo LM, Zulueta JJ (2017) Understanding the links between lung cancer, COPD, and emphysema: a key to more effective treatment and screening. Oncology (williston Park) 31(2):93–102
Siegel RL, Miller KD, Jemal A (2018) Cancer statistics. CA Cancer J Clin 68(1):7–30. https://doi.org/10.3322/caac.21442
Textor J, van der Zander B, Gilthorpe MK, Liskiewicz M, Ellison GTH (2016) Robust causal inference using directed acyclic graphs: the R package ‘dagitty.’ Int J Epidemiol 45(6):1887–1894
Torre LA, Siegel RL, Jemal A (2016) Lung cancer statistics. Adv Exp Med Biol 893:1–19. https://doi.org/10.1007/978-3-319-24223-1_1
Yang L, Lu X, Deng J et al (2015) Risk factors shared by COPD and lung cancer and mediation effect of COPD: two center case-control studies. Cancer Causes Control 26(1):11–24. https://doi.org/10.1007/s10552-014-0475-2
Young RP, Duan F, Chiles C et al (2015) Airflow limitation and histology shift in the National Lung Screening Trial. The NLST-ACRIN Cohort Substudy. Am J Respir Crit Care Med 192(9):1060–1067. https://doi.org/10.1164/rccm.201505-0894OC
Author information
Authors and Affiliations
Contributions
Humairat H. Rahman conceptualized the study and contributed to the introduction and discussion. Stuart H. Munson-McGee conducted the data analysis and contributed to the statistical method and the drafting of the paper. Danielle Niemann contributed to the drafting of the paper. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Ethics approval and consent to participate
Not applicable. This study uses only secondary data analyses without any personal information identified using statistical data from the NHANES website, no further ethical approval for conducting the present study is required.
Consent for publication
Consent was given by all the authors.
Competing interests
The authors declare no competing interests.
Additional information
Responsible Editor: Lotfi Aleya
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Rahman, H.H., Niemann, D. & Munson-McGee, S.H. Association between asthma, chronic bronchitis, emphysema, chronic obstructive pulmonary disease, and lung cancer in the US population. Environ Sci Pollut Res 30, 20147–20158 (2023). https://doi.org/10.1007/s11356-022-23631-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11356-022-23631-3