RATIONALE: Identification of risk factors for lung cancer can help in selecting patients who may benefit the most from smoking cessation interventions, early detection, or chemoprevention. OBJECTIVE: To evaluate whether the presence of emphysema on low-radiation-dose CT (LDCT) of the chest is an independent risk factor for lung cancer. METHODS: The study used data from a prospective cohort of 1,166 former and current smokers participating in a lung cancer screening study. All individuals underwent a baseline LDCT and spirometry followed by yearly repeat LDCT studies. The incidence density of lung cancer among patients with and without emphysema on LDCT was estimated. Stratified and multiple regression analyses were used to assess whether emphysema is an independent risk factor for lung cancer after adjusting for age, gender, smoking history, and the presence of airway obstruction on spirometry. RESULTS: On univariate analysis, the incidence density of lung cancer among individuals with and without emphysema on LDCT was 25.0 per 1,000 person-years and 7.5 per 1,000 person-years, respectively (risk ratio [RR], 3.33; 95% confidence interval [CI], 1.41 to 7.85). Emphysema was also associated with increased risk of lung cancer when the analysis was limited to individuals without airway obstruction on spirometry (RR, 4.33; 95% CI, 1.04 to 18.16). Multivariate analysis showed that the presence of emphysema (RR, 2.51; 95% CI, 1.01 to 6.23) on LDCT but not airway obstruction (RR, 2.10; 95% CI, 0.79 to 5.58) was associated with increased risk of lung cancer after adjusting for potential cofounders. CONCLUSIONS: Results suggest that the presence of emphysema on LDCT is an independent risk factor for lung cancer.
RATIONALE: Identification of risk factors for lung cancer can help in selecting patients who may benefit the most from smoking cessation interventions, early detection, or chemoprevention. OBJECTIVE: To evaluate whether the presence of emphysema on low-radiation-dose CT (LDCT) of the chest is an independent risk factor for lung cancer. METHODS: The study used data from a prospective cohort of 1,166 former and current smokers participating in a lung cancer screening study. All individuals underwent a baseline LDCT and spirometry followed by yearly repeat LDCT studies. The incidence density of lung cancer among patients with and without emphysema on LDCT was estimated. Stratified and multiple regression analyses were used to assess whether emphysema is an independent risk factor for lung cancer after adjusting for age, gender, smoking history, and the presence of airway obstruction on spirometry. RESULTS: On univariate analysis, the incidence density of lung cancer among individuals with and without emphysema on LDCT was 25.0 per 1,000 person-years and 7.5 per 1,000 person-years, respectively (risk ratio [RR], 3.33; 95% confidence interval [CI], 1.41 to 7.85). Emphysema was also associated with increased risk of lung cancer when the analysis was limited to individuals without airway obstruction on spirometry (RR, 4.33; 95% CI, 1.04 to 18.16). Multivariate analysis showed that the presence of emphysema (RR, 2.51; 95% CI, 1.01 to 6.23) on LDCT but not airway obstruction (RR, 2.10; 95% CI, 0.79 to 5.58) was associated with increased risk of lung cancer after adjusting for potential cofounders. CONCLUSIONS: Results suggest that the presence of emphysema on LDCT is an independent risk factor for lung cancer.
Authors: Pablo Sanchez-Salcedo; David O Wilson; Juan P de-Torres; Joel L Weissfeld; Juan Berto; Arantzazu Campo; Ana B Alcaide; Jesús Pueyo; Gorka Bastarrika; Luis M Seijo; Maria J Pajares; Ruben Pio; Luis M Montuenga; Javier J Zulueta Journal: Am J Respir Crit Care Med Date: 2015-04-15 Impact factor: 21.405
Authors: Antonello Punturieri; Thomas L Croxton; Gail G Weinmann; James P Kiley Journal: Am J Respir Crit Care Med Date: 2008-09-01 Impact factor: 21.405
Authors: Javier J Zulueta; Juan P Wisnivesky; Claudia I Henschke; Rowena Yip; Ali O Farooqi; Dorothy I McCauley; Mildred Chen; Daniel M Libby; James P Smith; Mark W Pasmantier; David F Yankelevitz Journal: Chest Date: 2011-10-20 Impact factor: 9.410
Authors: Antonio Gutierrez; Robert Suh; Fereidoun Abtin; Scott Genshaft; Kathleen Brown Journal: Semin Intervent Radiol Date: 2013-06 Impact factor: 1.513
Authors: David O Wilson; Joel L Weissfeld; Arzu Balkan; Jeffrey G Schragin; Carl R Fuhrman; Stephen N Fisher; Jonathan Wilson; Joseph K Leader; Jill M Siegfried; Steven D Shapiro; Frank C Sciurba Journal: Am J Respir Crit Care Med Date: 2008-06-19 Impact factor: 21.405
Authors: M Pallin; S Walsh; M F O'Driscoll; C Murray; A Cahalane; L Brown; M Carter; P Mitchell; T J McDonnell; M W Butler Journal: Lung Date: 2012-10-12 Impact factor: 2.584