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Chronic obstructive pulmonary disease and lung cancer incidence in never smokers: a cohort study
  1. Hye Yun Park1,
  2. Danbee Kang2,3,
  3. Sun Hye Shin1,
  4. Kwang-Ha Yoo4,
  5. Chin Kook Rhee5,
  6. Gee Young Suh1,
  7. Hojoong Kim1,
  8. Young Mog Shim6,
  9. Eliseo Guallar7,
  10. Juhee Cho2,3,7,
  11. O Jung Kwon1
  1. 1 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
  2. 2 Center for Clinical Epidemiology, Samsung Medical Center, Seoul, South Korea
  3. 3 Department of Clinical Research and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
  4. 4 Department of Internal Medicine, Konkuk University School of Medicine, Seoul, South Korea
  5. 5 Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
  6. 6 Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
  7. 7 Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
  1. Correspondence to Dr Juhee Cho, Center for Clinical Epidemiology, Samsung Medical Center, Seoul 06351, South Korea; jcho{at}skku.edu

Abstract

There has been limited evidence for the association between chronic obstructive pulmonary disease (COPD) and the incidence of lung cancer among never smokers. We aimed to estimate the risk of lung cancer incidence in never smokers with COPD, and to compare it with the risk associated with smoking. This cohort study involved 338 548 subjects, 40 to 84 years of age with no history of lung cancer at baseline, enrolled in the National Health Insurance Service National Sample Cohort. During 2 355 005 person-years of follow-up (median follow-up 7.0 years), 1834 participants developed lung cancer. Compared with never smokers without COPD, the fully-adjusted hazard ratios (95% CI) for lung cancer in never smokers with COPD, ever smokers without COPD, and ever smokers with COPD were 2.67 (2.09 to 3.40), 1.97 (1.75 to 2.21), and 6.19 (5.04 to 7.61), respectively. In this large national cohort study, COPD was also a strong independent risk factor for lung cancer incidence in never smokers, implying that COPD patients are at high risk of lung cancer, irrespective of smoking status.

  • COPD
  • lung cancer
  • never smokers
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Footnotes

  • HYP and DK contributed equally.

  • JC and OJK contributed equally.

  • Contributors Author contributions: Conception and design: HYP, DK, EG, JC, OJK. Data analysis: DK, EG, JC. Data interpretation and manuscript writing: HYP, DK, SHS, K-HY, CKR, GYS, HK, YMS, EG, JC, OJK. Revision of the manuscript and contribution to intellectual content: HYP, DK, SHS, KHY, CKR, GYS, HK, YMS, EG, JC, OJK.

  • Funding This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (no. 2017R1A2B2006435).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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