Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
Division of Pulmonology, Department of Internal Medicine, Institute of Chest Diseases, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Sci Rep. 2021 Jan 28;11(1):2596. doi: 10.1038/s41598-021-82182-8.
Idiopathic pulmonary fibrosis (IPF) is an independent risk factor for lung cancer (LC) development; however, there are currently no clinical guidelines for LC surveillance in IPF. This study aimed to investigate the cumulative incidence and survival outcomes of LC in IPF. Using the National Health Insurance Service database, including medical information on people aged ≥ 40 years between 2011 and 2016, we identified IPF patients and confirmed the presence of comorbid LC. Patients diagnosed with IPF in 2011 were washed out, and mortality data were analyzed from 2012 to 2018. A total of 7277 newly diagnosed IPF patients were identified among Korean citizens aged ≥ 40 years (about 50 million people) between 2011 and 2016. Their average age was 71.5 years and 72.8% of them were male. The prevalence of LC in the IPF cases was 6.4%. The cumulative incidence rates of LC in IPF patients who did not have LC at the time of IPF diagnosis were 1.7%, 4.7%, and 7.0%, at 1, 3, and 5 years, respectively. The median time from IPF diagnosis to LC development was 16.3 (Interquartile range, 8.2-28.8) months. The survival rate was significantly lower in the IPF with LC group than the IPF without LC group (P < 0.001). We concluded that IPF increases LC risk, and LC weakens survival outcomes in IPF. Close surveillance for LC development is mandatory for patients with IPF.
特发性肺纤维化（IPF）是肺癌（LC）发展的独立危险因素；然而，目前尚无 IPF 中 LC 监测的临床指南。本研究旨在调查 IPF 中 LC 的累积发病率和生存结果。使用国家健康保险服务数据库，包括 2011 年至 2016 年间年龄≥40 岁人群的医疗信息，我们确定了 IPF 患者并确认了合并 LC 的存在。2011 年诊断为 IPF 的患者被淘汰，从 2012 年至 2018 年分析死亡率数据。在 2011 年至 2016 年间，我们从韩国≥40 岁的公民中确定了 7277 名新诊断的 IPF 患者（约 5000 万人）。他们的平均年龄为 71.5 岁，其中 72.8%为男性。在 IPF 病例中，LC 的患病率为 6.4%。在 IPF 诊断时没有 LC 的 IPF 患者中，LC 的累积发病率分别为 1 年、3 年和 5 年时的 1.7%、4.7%和 7.0%。从 IPF 诊断到 LC 发展的中位时间为 16.3（四分位间距，8.2-28.8）个月。在有 LC 的 IPF 组中，生存率明显低于无 LC 的 IPF 组（P<0.001）。我们得出结论，IPF 增加了 LC 的风险，而 LC 则削弱了 IPF 患者的生存结果。对 IPF 患者进行 LC 发展的密切监测是强制性的。
