Is Previous Respiratory Disease a Risk Factor for Lung Cancer

R. Denholm, J. Schuz, K. Straif, I. Strucker, K-H. Jockel, D.R. Brenner, S. De Matteis, P. Boffetta, G. Guida, I. Bruske, H-E. Wichmann, M.T. Landi, N. Caporaso, J. Siemiatycki, W. Ahrens, H. Pohlabeln, D. Zaridze, J.K. Field, J. Mclaughlin, P. DemersN. Szeszenia-Dabrowska, J. Lissowska, P. Rudnai, E. Fabianova, R.S. Dumitru, V. Bencko, L. Foretova, V. Janout, B. Kendzia, Susan Peters, T. Behrens, R. Vermeulen, T. Bruning, H. Kromhout, A.C. Olsson

Research output: Contribution to journalArticlepeer-review

76 Citations (Scopus)


Rationale: Previous respiratory diseases have been associated with increased risk of lung cancer. Respiratory conditions often co-occur and few studies have investigated multiple conditions simultaneously.

Objectives: Investigate lung cancer risk associated with chronic bronchitis, emphysema, tuberculosis, pneumonia, and asthma.

Methods: The SYNERGY project pooled information on previous respiratory diseases from 12,739 case subjects and 14,945 control subjects from 7 case–control studies conducted in Europe and Canada. Multivariate logistic regression models were used to investigate the relationship between individual diseases adjusting for co-occurring conditions, and patterns of respiratory disease diagnoses and lung cancer. Analyses were stratified by sex, and adjusted for age, center, ever-employed in a high-risk occupation, education, smoking status, cigarette pack-years, and time since quitting smoking.

Measurements and Main Results: Chronic bronchitis and emphysema were positively associated with lung cancer, after accounting for other respiratory diseases and smoking (e.g., in men: odds ratio [OR], 1.33; 95% confidence interval [CI], 1.20–1.48 and OR, 1.50; 95% CI, 1.21–1.87, respectively). A positive relationship was observed between lung cancer and pneumonia diagnosed 2 years or less before lung cancer (OR, 3.31; 95% CI, 2.33–4.70 for men), but not longer. Co-occurrence of chronic bronchitis and emphysema and/or pneumonia had a stronger positive association with lung cancer than chronic bronchitis “only.” Asthma had an inverse association with lung cancer, the association being stronger with an asthma diagnosis 5 years or more before lung cancer compared with shorter.

Conclusions: Findings from this large international case–control consortium indicate that after accounting for co-occurring respiratory diseases, chronic bronchitis and emphysema continue to have a positive association with lung cancer.
Original languageEnglish
Pages (from-to)549-559
JournalAmerican Journal of Respiratory and Critical Care Medicine
Issue number6
Early online date23 Jul 2014
Publication statusPublished - 1 Sep 2014


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