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Factors associated with lung cancer in COPD patients
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.ORCID iD: 0000-0002-0370-8819
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
Statisticon AB, Uppsala, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
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2018 (English)In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 13, p. 1833-1839Article in journal (Refereed) Published
Abstract [en]

Background: The risk of dying of lung cancer is up to eightfold higher in patients with COPD than in age- and gender-matched controls. The aim of this study was to investigate the factors associated with lung cancer in a large cohort of COPD patients from primary care centers.

Methods: To analyze whether age, gender, socioeconomic factors, comorbidity, and medication affect the risk of lung cancer in COPD, we used a COPD cohort of primary care patients. Data from primary care medical records and mandatory Swedish national registers were collected and linked in this population-based, retrospective observational registry study (NCT01146392).

Results: Of the total cohort, 19,894 patients were included in the study. Five hundred and ninety-four lung cancer cases were diagnosed, corresponding to 3.0% of the studied population. In a multivariate analysis, the risk of lung cancer was lower if the COPD patients had a concurrent asthma diagnosis (HR: 0.54, CI: 0.41-0.71), while the risk of lung cancer increased with increasing age. A decreased lung cancer risk was observed in an exposure-dependent manner in patients who were prescribed inhaled corticosteroids (HR: 0.52, CI: 0.37-0.73), while the opposite was found for the use of acetylsalicylic acid (HR: 1.58, CI: 1.15-2.16).

Conclusion: In this large population-based cohort, a concurrent asthma diagnosis and use of inhaled corticosteroids were independently related to decreased risk of lung cancer in COPD patients, while the use of acetylsalicylic acid was associated with an increased risk. The findings of the present study should be seen as hypothesis generating and need to be confirmed in prospective studies.

Place, publisher, year, edition, pages
DOVE MEDICAL PRESS LTD , 2018. Vol. 13, p. 1833-1839
Keywords [en]
asthma, NSCLC, risk factor, ACO, inhaled corticosteroids
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:uu:diva-357778DOI: 10.2147/COPD.S162484ISI: 000434137100001PubMedID: 29922050OAI: oai:DiVA.org:uu-357778DiVA, id: diva2:1240810
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AstraZenecaAvailable from: 2018-08-22 Created: 2018-08-22 Last updated: 2018-08-22Bibliographically approved

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Sandelin, MartinMindus, StephanieLisspers, KarinStällberg, BjörnJohansson, GunnarJanson, Christer

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