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Spectrum of cancer risk among Taiwanese with chronic obstructive pulmonary disease

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Abstract

Background

Patients with chronic obstructive pulmonary disease (COPD) are liable to develop significant comorbidities, including lung cancer. Whether they are at a higher risk for cancer of other types remains debatable, especially for Asians. We studied the risk of incident cancer in COPD patients using a nationwide representative database, the Taiwan National Health Insurance Research Database.

Methods

From 1995 to 2008, 50,875 COPD patients who were free of antecedent malignancy were identified and followed up to development of malignancy, death or end of 2008, whichever came first. The risk of cancer was determined with the standardized incidence ratio (SIR), which is based on comparison to the national cancer incidence among the general population.

Results

During a median follow-up period of 5.61 years, 3623 (7.02 %) patients developed cancer and the SIR was 1.2 [95 % confidence interval (CI) 1.16-1.24, p < 0.001]. The risk remained higher at <1, 1–5, and even ≥5 years after the diagnosis of COPD (SIR 1.83, 1.07, and 1.11, respectively). Furthermore, the risk was significantly higher for some specific types of cancer, including head and neck cancer (SIR 1.23, 95 % CI 1.08–1.39, p = 0.002), esophageal cancer (SIR 1.35, 95 % CI 1.08–1.67, p = 0.010), lung and mediastinal cancer (SIR 1.86, 95 % CI 1.74–1.99, p < 0.001), breast cancer (SIR 1.19, 95 % CI 1.01–1.4, p = 0.041), prostate cancer (SIR 1.20, 95 % CI 1.06–1.35, p < 0.001), cancer of the central nervous system (SIR 1.58, 95 % CI 1.05–2.28, p = 0.030), lymphoma (SIR 1.53, 95 % CI 1.22–1.90, p < 0.001), and multiple myeloma (SIR 1.95, 95 % CI 1.31–2.80, p = 0.001).

Conclusion

COPD patients had increased risk for incident cancers, including lung cancer and several extrapulmonary cancers.

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Author notes

    Authors and Affiliations

    1. Department of Chest Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei, 112, Taiwan

      Chi-Lu Chiang, Chieh-Hung Wu, Yung-Hung Luo, Yuh-Min Chen, Kang-Cheng Su & Kun-Ta Chou

    2. Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan

      Yu-Wen Hu

    3. Division of Nephrology, Department of Medicine, Taipei City Hospital Heping Fuyou Branch, Taipei, Taiwan

      Yung-Tai Chen

    4. Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

      Chia-Jen Liu

    5. Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

      Tzeng-Ji Chen

    6. Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

      Kang-Cheng Su & Kun-Ta Chou

    7. Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan

      Chi-Lu Chiang, Yu-Wen Hu, Chieh-Hung Wu, Chia-Jen Liu, Yung-Hung Luo & Yuh-Min Chen

    8. Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei, Taiwan

      Tzeng-Ji Chen

    9. Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan

      Kun-Ta Chou

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    1. Chi-Lu Chiang
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    Correspondence to Kun-Ta Chou.

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    C.-L. Chiang and Y.-W. Hu contributed equally to this article.

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    Cite this article

    Chiang, CL., Hu, YW., Wu, CH. et al. Spectrum of cancer risk among Taiwanese with chronic obstructive pulmonary disease. Int J Clin Oncol 21, 1014–1020 (2016). https://doi.org/10.1007/s10147-016-0983-z

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    • DOI: https://doi.org/10.1007/s10147-016-0983-z

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