Article Text

other Versions

PDF

Cryptogenic fibrosing alveolitis and lung cancer: the BTS Study
  1. Jessica M Harris1,*,
  2. Ian D A Johnston2,
  3. Robin Rudd3,
  4. Anthony J Newman Taylor1,
  5. Paul Cullinan1
  1. 1 NHLI, Imperial College, United Kingdom;
  2. 2 Nottingham University Hospitals, United Kingdom;
  3. 3 London Lung Cancer Group, United Kingdom
  1. Correspondence to: JM Harris, Occupational & Environmental Medicine, National Heart and Lung Institute, Dept of Occupational and Environmental Medicine, Imperial College, (National Heart & Lung Institute), 1b Manresa Road, London, SW3 6LR, United Kingdom; jessica.harris{at}imperial.ac.uk

Abstract

Introduction: Risk of lung cancer is often reported as elevated for patients with cryptogenic fibrosing alveolitis (CFA).

Methods: Vital status was sought for all 588 members of the British Thoracic Society (BTS) cryptogenic fibrosing alveolitis (CFA) study eleven years after entry to the cohort. Observed deaths due to lung cancer were compared to expected, using age-, sex- and period-adjusted national rates. The roles of reported asbestos exposure and smoking were also investigated.

Results: 488 (83%) cohort members had died; 46 (9%) were certified to lung cancer (ICD9 162). The standardised mortality ratio (SMR) was 7.4 (95% ci [5.4, 9.9]). Stratified analysis demonstrated increased lung cancer mortality amongst younger subjects, males and ever smokers. Using an independent expert panel, 25 (4%) cohort members were considered to have at least moderate exposure to asbestos; lung cancer risk was elevated for these subjects (SMR 13.1 [3.6, 33.6]) versus 7.2 (5.2, 9.7) for those with less, or no, asbestos exposure. Ever smoking was reported by 448 (73%) of the cohort and was considerably higher in males (92%) than females (49%); p<0.001. Most (87%) lung cancer decedents were male and all but two (96%) lung cancer decedents ever smoked. Ever smokers presented at a younger age (mean 67 versus 70 years; p<0.001) and with less breathlessness (12% smokers reported no breathlessness versus 5% never smokers; p=0.02).

Discussion: These findings confirm an association between CFA and lung cancer although this relationship may not be causal. The high rate of smoking, and evidence that smokers present for medical attention earlier than non-smokers, suggest that smoking could be confounding this association.

Statistics from Altmetric.com

Footnotes

    Request permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Linked Articles

    • Airwaves
      Wisia Wedzicha