Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Center for Clinical Epidemiology, Samsung Medical Center, Seoul, South Korea.
Thorax. 2020 Jun;75(6):506-509. doi: 10.1136/thoraxjnl-2019-213732. Epub 2020 Apr 2.
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.
在从未吸烟者中，慢性阻塞性肺疾病（COPD）与肺癌发病率之间的关联证据有限。我们旨在评估 COPD 从未吸烟者肺癌发病率的风险，并将其与吸烟相关的风险进行比较。这项队列研究纳入了 338548 名年龄在 40 至 84 岁之间、基线时无肺癌病史的受试者，他们来自国民健康保险服务全国抽样队列。在 235.5 万 5 人年的随访期间（中位随访 7.0 年），有 1834 名参与者患上了肺癌。与无 COPD 的从未吸烟者相比，COPD 从未吸烟者、无 COPD 的曾吸烟者和有 COPD 的曾吸烟者肺癌的全调整危险比（95%置信区间）分别为 2.67（2.09 至 3.40）、1.97（1.75 至 2.21）和 6.19（5.04 至 7.61）。在这项大型全国性队列研究中，COPD 也是从未吸烟者肺癌发病率的一个强有力的独立危险因素，这意味着无论吸烟状况如何，COPD 患者都有罹患肺癌的高风险。
