Chronic obstructive pulmonary disease (COPD) is a strong independent risk factor for lung cancer in people who have never smoked, according to research published online in the journal Thorax today (3 Apr 2020). The risk is on a par with that of smokers without chronic lung disease, the findings indicate.
This cohort study involved 338,548 subjects aged 40-84 years with no history of lung cancer. During 2.35 million person-years of follow-up (median follow-up 7.0 years), 1,834 participants developed lung cancer.
Compared with never smokers without COPD, the fully-adjusted hazard ratios (HRs) for lung cancer in never smokers with COPD, ever smokers without COPD, and ever smokers with COPD were 2.67 (95% CI 2.09-3.40), 1.97 (95% CI 1.75-2.21), and 6.19 (95% CI 5.04-7.61), respectively.
The authors concluded that COPD is a strong independent risk factor for lung cancer in never-smokers. Furthermore, they reported that never-smokers with COPD had a similar risk of lung cancer compared with ever smokers without COPD.
They recommend that further studies should evaluate whether COPD patients are candidates for lung cancer screening, irrespective of smoking status.