Are airflow obstruction and radiographic evidence of emphysema risk factors for lung cancer? A nested case-control study using quantitative emphysema analysis

Fabien Maldonado, Brian Jack Bartholmai, Stephen J. Swensen, David Eric Midthun, Paul A. Decker, James R. Jett

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

Objectives: Several studies have identified airflow obstruction as a risk factor for lung cancer independent of smoking history, but the risk associated with the presence of radiographic evidence of emphysema has not been extensively studied. We proposed to assess this risk using a quantitative volumetric CT scan analysis. Methods: Sixty-four cases of lung cancer were identified from a prospective cohort of 1,520 participants enrolled in a spiral CT scan lung cancer screening trial. Each case was matched to six control subjects for age, sex, and smoking history. Quantitative CT scan analysis of emphysema was performed. Spirometric measures were also conducted. Data were analyzed using conditional logistic regression making use of the 1:6 set groups of 64 cases and 377 matched control subjects. Results: Decreased FEV 1 and FEV 1/FVC were significantly associated with a diagnosis of lung cancer with ORs of 1.15 (95% CI, 1.00-1.32; P = .046) and 1.29 (95% CI, 1.02-1.62; P = .031), respectively. The quantity of radiographic evidence of emphysema was not found to be a significant risk for lung cancer with OR of 1.042 (95% CI, 0.816-1.329; P = .743). Additionally, there was no significnt association between severe emphysema and lung cancer with OR of 1.57 (95% CI, 0.73-3.37). Conclusions: We confirm previous observations that airflow obstruction is an independent risk factor for lung cancer. The absence of a clear relationship between radiographic evidence of emphysema and lung cancer using an automated quantitative volumetric analysis may result from different population characteristics than those of prior studies, radiographic evidence of emphysema quantitation methodology, or absence of any relationship between emphysema and lung cancer risk.

Original languageEnglish (US)
Pages (from-to)1295-1302
Number of pages8
JournalChest
Volume138
Issue number6
DOIs
StatePublished - Dec 1 2010

Fingerprint

Emphysema
Case-Control Studies
Lung Neoplasms
Smoking
History
Cone-Beam Computed Tomography
Spiral Computed Tomography
Population Characteristics
Early Detection of Cancer
Logistic Models

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Are airflow obstruction and radiographic evidence of emphysema risk factors for lung cancer? A nested case-control study using quantitative emphysema analysis. / Maldonado, Fabien; Bartholmai, Brian Jack; Swensen, Stephen J.; Midthun, David Eric; Decker, Paul A.; Jett, James R.

In: Chest, Vol. 138, No. 6, 01.12.2010, p. 1295-1302.

Research output: Contribution to journalArticle

@article{23265aa13d454a0585a57ced66e55f25,
title = "Are airflow obstruction and radiographic evidence of emphysema risk factors for lung cancer? A nested case-control study using quantitative emphysema analysis",
abstract = "Objectives: Several studies have identified airflow obstruction as a risk factor for lung cancer independent of smoking history, but the risk associated with the presence of radiographic evidence of emphysema has not been extensively studied. We proposed to assess this risk using a quantitative volumetric CT scan analysis. Methods: Sixty-four cases of lung cancer were identified from a prospective cohort of 1,520 participants enrolled in a spiral CT scan lung cancer screening trial. Each case was matched to six control subjects for age, sex, and smoking history. Quantitative CT scan analysis of emphysema was performed. Spirometric measures were also conducted. Data were analyzed using conditional logistic regression making use of the 1:6 set groups of 64 cases and 377 matched control subjects. Results: Decreased FEV 1 and FEV 1/FVC were significantly associated with a diagnosis of lung cancer with ORs of 1.15 (95{\%} CI, 1.00-1.32; P = .046) and 1.29 (95{\%} CI, 1.02-1.62; P = .031), respectively. The quantity of radiographic evidence of emphysema was not found to be a significant risk for lung cancer with OR of 1.042 (95{\%} CI, 0.816-1.329; P = .743). Additionally, there was no significnt association between severe emphysema and lung cancer with OR of 1.57 (95{\%} CI, 0.73-3.37). Conclusions: We confirm previous observations that airflow obstruction is an independent risk factor for lung cancer. The absence of a clear relationship between radiographic evidence of emphysema and lung cancer using an automated quantitative volumetric analysis may result from different population characteristics than those of prior studies, radiographic evidence of emphysema quantitation methodology, or absence of any relationship between emphysema and lung cancer risk.",
author = "Fabien Maldonado and Bartholmai, {Brian Jack} and Swensen, {Stephen J.} and Midthun, {David Eric} and Decker, {Paul A.} and Jett, {James R.}",
year = "2010",
month = "12",
day = "1",
doi = "10.1378/chest.09-2567",
language = "English (US)",
volume = "138",
pages = "1295--1302",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "6",

}

TY - JOUR

T1 - Are airflow obstruction and radiographic evidence of emphysema risk factors for lung cancer? A nested case-control study using quantitative emphysema analysis

AU - Maldonado, Fabien

AU - Bartholmai, Brian Jack

AU - Swensen, Stephen J.

AU - Midthun, David Eric

AU - Decker, Paul A.

AU - Jett, James R.

PY - 2010/12/1

Y1 - 2010/12/1

N2 - Objectives: Several studies have identified airflow obstruction as a risk factor for lung cancer independent of smoking history, but the risk associated with the presence of radiographic evidence of emphysema has not been extensively studied. We proposed to assess this risk using a quantitative volumetric CT scan analysis. Methods: Sixty-four cases of lung cancer were identified from a prospective cohort of 1,520 participants enrolled in a spiral CT scan lung cancer screening trial. Each case was matched to six control subjects for age, sex, and smoking history. Quantitative CT scan analysis of emphysema was performed. Spirometric measures were also conducted. Data were analyzed using conditional logistic regression making use of the 1:6 set groups of 64 cases and 377 matched control subjects. Results: Decreased FEV 1 and FEV 1/FVC were significantly associated with a diagnosis of lung cancer with ORs of 1.15 (95% CI, 1.00-1.32; P = .046) and 1.29 (95% CI, 1.02-1.62; P = .031), respectively. The quantity of radiographic evidence of emphysema was not found to be a significant risk for lung cancer with OR of 1.042 (95% CI, 0.816-1.329; P = .743). Additionally, there was no significnt association between severe emphysema and lung cancer with OR of 1.57 (95% CI, 0.73-3.37). Conclusions: We confirm previous observations that airflow obstruction is an independent risk factor for lung cancer. The absence of a clear relationship between radiographic evidence of emphysema and lung cancer using an automated quantitative volumetric analysis may result from different population characteristics than those of prior studies, radiographic evidence of emphysema quantitation methodology, or absence of any relationship between emphysema and lung cancer risk.

AB - Objectives: Several studies have identified airflow obstruction as a risk factor for lung cancer independent of smoking history, but the risk associated with the presence of radiographic evidence of emphysema has not been extensively studied. We proposed to assess this risk using a quantitative volumetric CT scan analysis. Methods: Sixty-four cases of lung cancer were identified from a prospective cohort of 1,520 participants enrolled in a spiral CT scan lung cancer screening trial. Each case was matched to six control subjects for age, sex, and smoking history. Quantitative CT scan analysis of emphysema was performed. Spirometric measures were also conducted. Data were analyzed using conditional logistic regression making use of the 1:6 set groups of 64 cases and 377 matched control subjects. Results: Decreased FEV 1 and FEV 1/FVC were significantly associated with a diagnosis of lung cancer with ORs of 1.15 (95% CI, 1.00-1.32; P = .046) and 1.29 (95% CI, 1.02-1.62; P = .031), respectively. The quantity of radiographic evidence of emphysema was not found to be a significant risk for lung cancer with OR of 1.042 (95% CI, 0.816-1.329; P = .743). Additionally, there was no significnt association between severe emphysema and lung cancer with OR of 1.57 (95% CI, 0.73-3.37). Conclusions: We confirm previous observations that airflow obstruction is an independent risk factor for lung cancer. The absence of a clear relationship between radiographic evidence of emphysema and lung cancer using an automated quantitative volumetric analysis may result from different population characteristics than those of prior studies, radiographic evidence of emphysema quantitation methodology, or absence of any relationship between emphysema and lung cancer risk.

UR - http://www.scopus.com/inward/record.url?scp=78649806069&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78649806069&partnerID=8YFLogxK

U2 - 10.1378/chest.09-2567

DO - 10.1378/chest.09-2567

M3 - Article

VL - 138

SP - 1295

EP - 1302

JO - Chest

JF - Chest

SN - 0012-3692

IS - 6

ER -