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Prior Lung Disease and Risk of Lung Cancer in a Large Prospective Study

Cancer Causes & Control volume 15, pages 819–827 (2004)Cite this article

Abstract

Objectives: While 75-90% of people who develop lung cancer are smokers, only a small proportion of smokers develop lung cancer. Identifying factors that increase a smoker's risk of developing lung cancer may help scientists to better understand the etiology of lung cancer and more effectively target high-risk groups for screening.

Methods: Information on physician-diagnosed non-malignant lung diseases [asbestosis, asthma, chronic bronchitis or emphysema (CB/E), pneumonia, and tuberculosis] was obtained at baseline from 17,698 men and women involved in CARET, a randomized lung cancer prevention trial of beta-carotene and vitamin A among heavy smokers and asbestos-exposed workers. Hazard ratios for lung cancer were estimated through Cox regression models, after controlling for potential confounding factors, included smoking. Analyses were restricted to former and current smokers.

Results: During a median follow up of 9.1 years, 1028 cases of lung cancer occurred. Those who developed lung cancer were more likely to report a history of CB/E than controls (adjusted HR = 1.29, 95% CI: 1.09-1.53). In subgroup analyses, the association between a history of CB/E and lung cancer was stronger for those who were younger at diagnosis/reference, men in the heavy smoker cohort, former smokers, and those with squamous cell carcinomas. There was little association between a history of other lung diseases and lung cancer.

Conclusions: Smokers with a history of CB/E may be at higher risk of developing lung cancer, independent of their smoking history.

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Author information

Authors and Affiliations

  1. Department of Epidemiology, University of Washington, Seattle, WA, USA

    Alyson J. Littman, Emily White & Lisa A. Jackson

  2. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, M4 B402, Seattle, WA, 98109-1024, USA

    Alyson J. Littman, Mark D. Thornquist, Emily White, Gary E. Goodman & Thomas L. Vaughan

  3. Center for Health Studies, Group Health Cooperative, Seattle, WA, USA

    Lisa A. Jackson

  4. Swedish Cancer Institute, Seattle, WA, USA

    Gary E. Goodman

  5. Department of Epidemiology, University of Washington, Seattle, WA, USA

    Thomas L. Vaughan

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  1. Alyson J. Littman
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  2. Mark D. Thornquist
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  3. Emily White
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Littman, A.J., Thornquist, M.D., White, E. et al. Prior Lung Disease and Risk of Lung Cancer in a Large Prospective Study. Cancer Causes Control 15, 819–827 (2004). https://doi.org/10.1023/B:CACO.0000043432.71626.45

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  • DOI: https://doi.org/10.1023/B:CACO.0000043432.71626.45

  • lung cancer
  • prospective study
  • chronic bronchitis
  • lung diseases
  • epidemiology