Is previous respiratory disease a risk factor for lung cancer?

Denholm, R; Schüz, J; Straif, K; Stücker, I; Jöckel, K; Brenner, DR; De Matteis, S; Boffetta, P; Guida, F; Brüske, I; +25 more...Wichmann, H; Landi, MT; Caporaso, N; Siemiatycki, J; Ahrens, W; Pohlabeln, H; Zaridze, D; Field, JK; McLaughlin, J; Demers, P; Szeszenia-Dabrowska, N; Lissowska, J; Rudnai, P; Fabianova, E; Dumitru, RS; Bencko, V; Foretova, L; Janout, V; Kendzia, B; Peters, S; Behrens, T; Vermeulen, R; Brüning, T; Kromhout, H; C Olsson, A and (2014) Is previous respiratory disease a risk factor for lung cancer? American journal of respiratory and critical care medicine, 190 (5). pp. 549-559. ISSN 1073-449X DOI: 10.1164/rccm.201402-0338OC
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RATIONALE: Previous respiratory diseases have been associated with increased risk of lung cancer. Respiratory conditions often co-occur and few studies have investigated multiple conditions simultaneously. OBJECTIVES: Investigate lung cancer risk associated with chronic bronchitis, emphysema, tuberculosis, pneumonia, and asthma. METHODS: The SYNERGY project pooled information on previous respiratory diseases from 12,739 case subjects and 14,945 control subjects from 7 case-control studies conducted in Europe and Canada. Multivariate logistic regression models were used to investigate the relationship between individual diseases adjusting for co-occurring conditions, and patterns of respiratory disease diagnoses and lung cancer. Analyses were stratified by sex, and adjusted for age, center, ever-employed in a high-risk occupation, education, smoking status, cigarette pack-years, and time since quitting smoking. MEASUREMENTS AND MAIN RESULTS: Chronic bronchitis and emphysema were positively associated with lung cancer, after accounting for other respiratory diseases and smoking (e.g., in men: odds ratio [OR], 1.33; 95% confidence interval [CI], 1.20-1.48 and OR, 1.50; 95% CI, 1.21-1.87, respectively). A positive relationship was observed between lung cancer and pneumonia diagnosed 2 years or less before lung cancer (OR, 3.31; 95% CI, 2.33-4.70 for men), but not longer. Co-occurrence of chronic bronchitis and emphysema and/or pneumonia had a stronger positive association with lung cancer than chronic bronchitis "only." Asthma had an inverse association with lung cancer, the association being stronger with an asthma diagnosis 5 years or more before lung cancer compared with shorter. CONCLUSIONS: Findings from this large international case-control consortium indicate that after accounting for co-occurring respiratory diseases, chronic bronchitis and emphysema continue to have a positive association with lung cancer.

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