Chi-Lu Chiang1,2, Yu-Wen Hu3,2, Chieh-Hung Wu1,2, Yung-Tai Chen4, Chia-Jen Liu5,2, Yung-Hung Luo1,2, Yuh-Min Chen1,2, Tzeng-Ji Chen6,7, Kang-Cheng Su1,8, Kun-Ta Chou9,10,11. 1. Department of Chest Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei, 112, Taiwan. 2. Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. 3. Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan. 4. Division of Nephrology, Department of Medicine, Taipei City Hospital Heping Fuyou Branch, Taipei, Taiwan. 5. Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 6. Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 7. Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei, Taiwan. 8. Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 9. Department of Chest Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei, 112, Taiwan. hbjoue@vghtpe.gov.tw. 10. Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. hbjoue@vghtpe.gov.tw. 11. Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. hbjoue@vghtpe.gov.tw.
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.
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 COPDpatients using a nationwide representative database, the Taiwan National Health Insurance Research Database. METHODS: From 1995 to 2008, 50,875 COPDpatients 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:COPDpatients had increased risk for incident cancers, including lung cancer and several extrapulmonary cancers.
Authors: Lisiane B Meira; James M Bugni; Stephanie L Green; Chung-Wei Lee; Bo Pang; Diana Borenshtein; Barry H Rickman; Arlin B Rogers; Catherine A Moroski-Erkul; Jose L McFaline; David B Schauer; Peter C Dedon; James G Fox; Leona D Samson Journal: J Clin Invest Date: 2008-07 Impact factor: 14.808
Authors: Avinoam Nevler; Samantha Z Brown; David Nauheim; Carla Portocarrero; Ulrich Rodeck; Jonathan Bassig; Christopher W Schultz; Grace A McCarthy; Harish Lavu; Theresa P Yeo; Charles J Yeo; Jonathan R Brody Journal: J Am Coll Surg Date: 2020-02-11 Impact factor: 6.113