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

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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References

  1. Blot WJ, Fraumeni JF Jr (1996)Cancers of the lung and pleura.In:Fraumeni JF,Jr ed.Cancer Epidemiology and Prevention.Oxford: Oxford University Press,pp.637-665.

    Google Scholar 

  2. Osann KE, Lowery JT, Schell MJ (2000)Small cell lung cancer in women:risk associated with smoking,prior respiratory disease, and occupation.Lung Cancer 28:1-10.

    Article  PubMed  Google Scholar 

  3. Brownson RC, Alavanja MC (2000)Previous lung disease and lung cancer risk among women (United States).Cancer Causes Control 11:853-858.

    Article  PubMed  Google Scholar 

  4. Mayne ST, Buenconsejo J, Janerich DT (1999)Previous lung disease and risk of lung cancer among men and women nonsmok-ers.Am J Epidemiol 149:13-20.

    PubMed  Google Scholar 

  5. Wu AH, Fontham ET, Reynolds P,et al.(1995)Previous lung disease and risk of lung cancer among lifetime nonsmoking women in the United States.Am J Epidemiol 141:1023-1032.

    PubMed  Google Scholar 

  6. Wu-Williams AH, Dai XD, Blot W,et al.(1990)Lung cancer among women in north-east China.Br J Cancer 62:982-987.

    PubMed  Google Scholar 

  7. Samet JM, Humble CG, Pathak DR (1986)Personal and family history of respiratory disease and lung cancer risk.Am Rev Respir Dis 134:466-470.

    PubMed  Google Scholar 

  8. Alavanja MC, Brownson RC, Boice JD Jr, Hock E (1992) Preexisting lung disease and lung cancer among nonsmoking women.Am J Epidemiol 136:623-632.

    PubMed  Google Scholar 

  9. Islam SS, Schottenfeld D (1994)Declining FEV1 and chronic productive cough in cigarette smokers:a 25-year prospective study of lung cancer incidence in Tecumseh,Michigan.Cancer Epidemiol Biomarkers Prev 3:289-298.

    PubMed  Google Scholar 

  10. Sasco AJ, Merrill RM, Dari I,et al.(2002)A case-control study of lung cancer in Casablanca,Morocco.Cancer Causes Control 13:609-616.

    Article  PubMed  Google Scholar 

  11. Ger LP, Hsu WL, Chen KT, Chen CJ (1993)Risk factors of lung cancer by histological category in Taiwan.Anticancer Res 13: 1491-1500.

    PubMed  Google Scholar 

  12. Omenn GS, Goodman G, Thornquist M,et al.(1996)Chemoprevention of lung cancer:the beta-Carotene and Retinol Ecacy Trial (CARET)in high-risk smokers and asbestos-exposed workers.IARC Sci Publ:67-85.

  13. Omenn GS, Goodman GE,Thornquist MD,et al.(1996)Effects of a combination of beta-carotene and vitamin A on lung cancer and cardiovascular disease.N Engl J Med 334:1150-1155.

    Article  PubMed  Google Scholar 

  14. Ferris BG (1978)Epidemiology Standardization Project (American Thoracic Society).Am Rev Respir Dis 118:1-120.

    Google Scholar 

  15. Bobadilla A, Guerra S, Sherrill D, Barbee R (2002)How accurate is the self-reported diagnosis of chronic bronchitis?Chest 122: 1234-1239.

    Google Scholar 

  16. Omenn GS, Goodman GE, Thornquist MD,et al.(1993)The Carotene and Retinol Ecacy Trial (CARET)to prevent lung cancer in high-risk populations:pilot study with asbestos-exposed workers.Cancer Epidemiol Biomarkers Prev 2:381-387.

    PubMed  Google Scholar 

  17. Crapo RO, Morris AH, Gardner RM (1981)Reference spirometric values using techniques and equipment that meet ATS recommen-dations.Am Rev Respir Dis 123:659-664.

    PubMed  Google Scholar 

  18. Fritz AG (2000)International Classi cation of Diseases for Oncology:ICD-O.World Health Organization,Geneva.

  19. Hosmer DW, Lemeshow S (1999)Applied Survival Analysis: Regression Modeling of Time to Event Data.Wiley, New York.

    Google Scholar 

  20. Albanes D, Heinonen OP, Taylor PR,et al.(1996)Alpha-tocopherol and beta-carotene supplements and lung cancer inci-dence in the alpha-tocopherol,beta-carotene cancer prevention study:effects of base-line characteristics and study compliance.J Natl Cancer Inst 88:1560-1570.

    PubMed  Google Scholar 

  21. Surveillance,Epidemiology,and End Results (SEER)Program (www.seer.cancer.gov).Incidence-SEER 9 Regs Public-Use,Nov 2002 Sub (1973-2000).National Cancer Institute,DCCPS,Sur-veillance Research Program,Cancer Statistics Branch.

  22. Brenner AV, Wang Z, Kleinerman RA,et al.(2001)Previous pulmonary diseases and risk of lung cancer in Gansu Province, China.Int J Epidemiol 30:118-124.

    Article  PubMed  Google Scholar 

  23. Gao YT, Blot WJ, Zheng W,et al.(1987)Lung cancer among Chinese women.Int J Cancer40:604-609.

    PubMed  Google Scholar 

  24. Ko YC, Lee CH, Chen MJ,et al.(1997)Risk factors for primary lung cancer among non-smoking women in Taiwan.Int J Epidemiol 26:24-31.

    Article  PubMed  Google Scholar 

  25. Kreuzer M, Gerken M, Kreienbrock L, Wellmann J, Wichmann HE (2001)Lung cancer in lifetime nonsmoking men-results of a case-control study in Germany.Br J Cancer 84:134-140.

    Article  PubMed  Google Scholar 

  26. Kreuzer M, Heinrich J, Kreienbrock L, Rosario AS, Gerken M, Wichmann HE (2002)Risk factors for lung cancer among nonsmoking women.Int J Cancer 100:706-713.

    Article  PubMed  Google Scholar 

  27. Kubik AK, Zatloukal P, Tomasek L, Petruzelka L (2002)Lung cancer risk among Czech women:a case-control study.Prev Med 34:436-444.

    Article  PubMed  Google Scholar 

  28. Osann KE (1991)Lung cancer in women:the importance of smoking,family history of cancer,and medical history of respiratory disease.Cancer Res 51:4893-4897.

    PubMed  Google Scholar 

  29. Eberly LE, Ockene J, Sherwin R, Yang L, Kuller L (2003) Pulmonary function as a predictor of lung cancer mortality in continuing cigarette smokers and in quitters.Int J Epidemiol 32: 592-599.

    Article  PubMed  Google Scholar 

  30. Mannino DM, Buist AS, Petty TL, Enright PL, Redd SC (2003) Lung function and mortality in the United States:data from the First National Health and Nutrition Examination Survey follow up study.Thorax 58:388-393.

    Article  PubMed  Google Scholar 

  31. Skillrud DM, Offord KP, Miller RD (1986)Higher risk of lung cancer in chronic obstructive pulmonary disease.A prospective, matched,controlled study.Ann Intern Med 105:503-507.

    PubMed  Google Scholar 

  32. Mannino DM (2002)COPD:epidemiology,prevalence,morbidity and mortality,and disease heterogeneity.Chest 121:121S-126S.

    Article  PubMed  Google Scholar 

  33. Barr RG, Herbstman J, Speizer FE, Camargo CA Jr (2002) Validation of self-reported chronic obstructive pulmonary disease in a cohort study of nurses.Am J Epidemiol 155:965-971.

    Article  PubMed  Google Scholar 

  34. Leffondre K, Abrahamowicz M, Siemiatycki J, Rachet B (2002) Modeling smoking history:a comparison of different approaches.Am J Epidemiol 156:813-823.

    Article  PubMed  Google Scholar 

  35. Yang P, Wentzlaff KA, Katzmann JA,et al.(1999)Alpha1-antitrypsin de ciency allele carriers among lung cancer patients. Cancer Epidemiol Biomarkers Prev 8:461-465.

    PubMed  Google Scholar 

  36. Piquette CA, Rennard SI, Snider GL (2000)Chronic bronchitis and emphysema.In:Nadel JA,(ed.),Textbook of Respiratory Medicine.Philadelphia: W.B.Saunders Company,pp.1187-1217.

    Google Scholar 

  37. Cohen BH, Diamond EL, Graves CG,et al.(1977)A common familial component in lung cancer and chronic obstructive pulmonary disease.Lancet 2:523-526.

    Article  PubMed  Google Scholar 

  38. Tager I, Tishler PV, Rosner B, Speizer FE, Litt M (1978)Studies of the familial aggregation of chronic bronchitis and obstructive airways disease.Int J Epidemiol 7:55-62.

    PubMed  Google Scholar 

  39. Higgins M, Keller J (1975)Familial occurrence of chronic respiratory disease and familial resemblance in ventilatory capac-ity.J Chronic Dis 28:239-251.

    Article  PubMed  Google Scholar 

  40. Kueppers F, Miller RD, Gordon H, Hepper NG, Offord K (1977) Familial prevalence of chronic obstructive pulmonary disease in a matched pair study.Am J Med 63:336-342.

    Article  PubMed  Google Scholar 

  41. Khoury MJ, Beaty TH, Newill CA, Bryant S, Cohen BH (1986) Genetic-environmental interactions in chronic airways obstruction. Int J Epidemiol 15:65-72.

    PubMed  Google Scholar 

  42. Silverman EK, Chapman HA, Drazen JM,et al.(1998)Genetic epidemiology of severe,early-onset chronic obstructive pulmonary disease.Risk to relatives for air flow obstruction and chronic bronchitis.Am J Respir Crit Care Med 157:1770-1778.

    PubMed  Google Scholar 

  43. Cohen BH (1978)Is pulmonary dysfunction the common denominator for the multiple effects of cigarette smoking?Lancet 2:1024-1027.

    Article  PubMed  Google Scholar 

  44. Ames BN, Shigenaga MK, Gold LS (1993)DNA lesions,inducible DNA repair,and cell division:three key factors in mutagenesis and carcinogenesis.Environ Health Perspect 101 (Suppl.5):35-44.

    Google Scholar 

  45. Cohen SM, Ellwein LB (1990)Cell proliferation in carcinogenesis. Science 249:1007-1011.

    PubMed  Google Scholar 

  46. London WT,McGlynn KA (1996)Liver cancer.In:Fraumeni JF Jr,ed.Cancer Epidemiology and Prevention.New York: Oxford University Press,pp.772-793.

    Google Scholar 

  47. Farrow DC, Vaughan TL, Sweeney C,et al.(2000)Gastroesoph-ageal relux disease,use of H2 receptor antagonists,and risk of esophageal and gastric cancer.Cancer Causes Control11:231-238.

    Article  PubMed  Google Scholar 

  48. Nomura A (1996)Stomach cancer.In:Fraumeni JF Jr,ed.Cancer Epidemiology and Prevention.New York: Oxford University Press,pp.707-724.

    Google Scholar 

  49. Schottenfeld D, Winawer SJ (1996)Cancers of the large intestine. In:Fraumeni JF Jr,ed.Cancer Epidemiology and Prevention.New York: Oxford University Press,pp.813-840.

    Google Scholar 

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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