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. 2012 Oct 1;176(7):573-85.
doi: 10.1093/aje/kws151. Epub 2012 Sep 17.

Previous lung diseases and lung cancer risk: a pooled analysis from the International Lung Cancer Consortium

Darren R Brenner  1 , Paolo Boffetta, Eric J Duell, Heike Bickeböller, Albert Rosenberger, Valerie McCormack, Joshua E Muscat, Ping Yang, H-Erich Wichmann, Irene Brueske-Hohlfeld, Ann G Schwartz, Michele L Cote, Anne Tjønneland, Søren Friis, Loic Le Marchand, Zuo-Feng Zhang, Hal Morgenstern, Neonila Szeszenia-Dabrowska, Jolanta Lissowska, David Zaridze, Peter Rudnai, Eleonora Fabianova, Lenka Foretova, Vladimir Janout, Vladimir Bencko, Miriam Schejbalova, Paul Brennan, Ioan N Mates, Philip Lazarus, John K Field, Olaide Raji, John R McLaughlin, Geoffrey Liu, John Wiencke, Monica Neri, Donatella Ugolini, Angeline S Andrew, Qing Lan, Wei Hu, Irene Orlow, Bernard J Park, Rayjean J Hung
Affiliations

Previous lung diseases and lung cancer risk: a pooled analysis from the International Lung Cancer Consortium

Darren R Brenner et al. Am J Epidemiol. .

Abstract

To clarify the role of previous lung diseases (chronic bronchitis, emphysema, pneumonia, and tuberculosis) in the development of lung cancer, the authors conducted a pooled analysis of studies in the International Lung Cancer Consortium. Seventeen studies including 24,607 cases and 81,829 controls (noncases), mainly conducted in Europe and North America, were included (1984-2011). Using self-reported data on previous diagnoses of lung diseases, the authors derived study-specific effect estimates by means of logistic regression models or Cox proportional hazards models adjusted for age, sex, and cumulative tobacco smoking. Estimates were pooled using random-effects models. Analyses stratified by smoking status and histology were also conducted. A history of emphysema conferred a 2.44-fold increased risk of lung cancer (95% confidence interval (CI): 1.64, 3.62 (16 studies)). A history of chronic bronchitis conferred a relative risk of 1.47 (95% CI: 1.29, 1.68 (13 studies)). Tuberculosis (relative risk = 1.48, 95% CI: 1.17, 1.87 (16 studies)) and pneumonia (relative risk = 1.57, 95% CI: 1.22, 2.01 (12 studies)) were also associated with lung cancer risk. Among never smokers, elevated risks were observed for emphysema, pneumonia, and tuberculosis. These results suggest that previous lung diseases influence lung cancer risk independently of tobacco use and that these diseases are important for assessing individual risk.

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Figures

Figure 1.
Figure 1.
Results from a pooled analysis of emphysema as a risk factor for the development of lung cancer, International Lung Cancer Consortium, 1984–2011. The graph shows a forest plot of the association between emphysema and lung cancer risk by study center, smoking status, and histologic type. Models adjusted for age, sex, and pack-years of smoking. P values are from a test for heterogeneity across studies or across subgroups. “With removals” represents removal of the Mayo, Central Europe, HMGU, WSU/KCI-2, and UCLA studies. See Table 1 for published references. (CI, confidence interval; CREST, CREST (Cancer of the Respiratory Tract) Biorepository; Danish, Danish Diet, Cancer, and Health Study; HMGU, Helmholtz Center Munich; KCI, Karmanos Cancer Institute; Liverpool, Liverpool Lung Project; NCI, National Cancer Institute; NELCS, New England Lung Cancer Study; New York, New York Multicenter Study; OR, odds ratio; RR, relative risk; SCC, squamous cell carcinoma; SCLC, small cell lung cancer; Toronto, Samuel Lunenfeld Research Institute; UCLA, University of California, Los Angeles; UCSF, University of California, San Francisco; WSU, Wayne State University; WSU/KCI-1, Family Health Study; WSU/KCI-2, study of women's lung cancer epidemiology).
Figure 2.
Figure 2.
Results from a pooled analysis of chronic bronchitis as a risk factor for the development of lung cancer, International Lung Cancer Consortium, 1984–2011. The graph shows a forest plot of the association between chronic bronchitis and lung cancer risk by study center, smoking status, and histologic type. Models adjusted for age, sex, and pack-years of smoking. P values are from a test for heterogeneity across studies or across subgroups. (CI, confidence interval; CREST, CREST (Cancer of the Respiratory Tract) Biorepository; Danish, Danish Diet, Cancer, and Health Study; HMGU, Helmholtz Center Munich; KCI, Karmanos Cancer Institute; MSKCC, Memorial Sloan-Kettering Cancer Center; NELCS, New England Lung Cancer Study; New York, New York Multicenter Study; NCI, National Cancer Institute; OR, odds ratio; RR, relative risk; SCC, squamous cell carcinoma; SCLC, small cell lung cancer; Toronto, Samuel Lunenfeld Research Institute; UCLA, University of California, Los Angeles; WSU, Wayne State University; WSU/KCI-1, Family Health Study; WSU/KCI-2, study of women's lung cancer epidemiology).
Figure 3.
Figure 3.
Results from a pooled analysis of pneumonia as a risk factor for the development of lung cancer, International Lung Cancer Consortium, 1984–2011. The graph shows a forest plot of the association between pneumonia and lung cancer risk by study center, smoking status, and histologic type. Models adjusted for age, sex, and pack-years of smoking. P values are from a test for heterogeneity across studies or across subgroups. “With removals” represents removal of the Toronto, WSU/KCI-2, UCSF, Mayo, and Danish studies. (CI, confidence interval; CREST, CREST (Cancer of the Respiratory Tract) Biorepository; Danish, Danish Diet, Cancer, and Health Study; HMGU, Helmholtz Center Munich; KCI, Karmanos Cancer Institute; Liverpool, Liverpool Lung Project; NELCS, New England Lung Cancer Study; OR, odds ratio; RR, relative risk; SCC, squamous cell carcinoma; SCLC, small cell lung cancer; Toronto, Samuel Lunenfeld Research Institute; UCLA, University of California, Los Angeles; UCSF, University of California, San Francisco; WSU, Wayne State University; WSU/KCI-1, Family Health Study; WSU/KCI-2, study of women's lung cancer epidemiology).
Figure 4.
Figure 4.
Results from a pooled analysis of tuberculosis as a risk factor for the development of lung cancer, International Lung Cancer Consortium, 1984–2011. The graph shows a forest plot of the association between tuberculosis and lung cancer risk by study center, smoking status, and histologic type. Models adjusted for age, sex, and pack-years of smoking. P values are from a test for heterogeneity across studies or across subgroups. “With removal” represents removal of the HMGU study. (CI, confidence interval; CREST, CREST (Cancer of the Respiratory Tract) Biorepository; Danish, Danish Diet, Cancer, and Health Study; HMGU, Helmholtz Center Munich; KCI, Karmanos Cancer Institute; Liverpool, Liverpool Lung Project; MSKCC, Memorial Sloan-Kettering Cancer Center; NCI, National Cancer Institute; NELCS, New England Lung Cancer Study; New York, New York Multicenter Study; OR, odds ratio; RR, relative risk; SCC, squamous cell carcinoma; SCLC, small cell lung cancer; Toronto, Samuel Lunenfeld Research Institute; UCLA, University of California, Los Angeles; UCSF, University of California, San Francisco; WSU, Wayne State University; WSU/KCI-1, Family Health Study; WSU/KCI-2, study of women's lung cancer epidemiology).
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