Higher risk of lung cancer in chronic obstructive pulmonary disease. A prospective, matched, controlled study.

To assess the risk of lung cancer in patients with chronic obstructive pulmonary disease, we matched, on the basis of age, sex, occupation, and smoking history, 113 persons ("cases") who had a forced expiratory volume in 1 second (FEV1) of 70% or less of predicted normal with 113 control persons who had an FEV1 of 85% or more. All persons were observed from 1973-74 through 1984 for a diagnosis of lung cancer, death from lung cancer, and death from any cause. At entry, subjects had an age range of 45 to 59 years; men numbered 186 and women 40. Histologically proven lung cancer developed in 9 cases and in 2 controls, all men. The rate of development of lung cancer was significantly different in the two groups (p = 0.024): the 10-year cumulative percentage was 8.8% for cases and 2.0% for controls. Overall 10-year survival was estimated to be 74.0% for cases and 91.1% for controls (p less than 0.001).