Journal
EUROPEAN RESPIRATORY JOURNAL
Volume 35, Issue 1, Pages 146-151Publisher
EUROPEAN RESPIRATORY SOC JOURNALS LTD
DOI: 10.1183/09031936.00049909
Keywords
Lung cancer risk; lung damage; lung function; spiral computed tomography screening
Categories
Funding
- Italian Ministry of Health (Ricerca Finalizzata
- Rome, Italy)
- Italian Association for Cancer Research (AIRC
- Milan, Italy)
- Fondazione Cariplo (Milan, Italy)
- Lombardy Region
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The relationship between smoking, lung cancer and airflow obstruction is recognised but it is unclear whether the presence of minimal lung function damage constitutes an independent risk factor for the development of lung cancer. In order to identify those individuals at higher risk of lung cancer on the basis of functional impairment, we evaluated baseline pulmonary function tests of 3,806 heavy smokers undergoing annual chest computed tomography screening, and compared the forced expiratory volume in 1 s (FEV1) % predicted of 57 lung cancer cases and that of 3,749 subjects without cancer. We obtained odds ratios (ORs) of lung cancer and the corresponding 95% confidence intervals (CIs) using unconditional logistic regression, adjusting for age, sex, study and smoking variables. Compared with subjects with FEV1 >= 90% pred, the OR of lung cancer was 2.45 (95% CI 1.39-4.33) for subjects with FEV1 <90% pred and 2.90 (95% CI 1.34-6.27) for subjects with FEV1 <70% pred. These data show that even a relatively small reduction in FEV1 % pred is a significant predictor of increased lung cancer risk. Test screening for lung cancer using airflow obstruction with FEV1 <90% is a strategy worth future consideration.
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