Chronic obstructive pulmonary disease and risk of lung cancer: a meta-analysis of prospective cohort studies

Xinyue Zhang, Ning Jiang _, Lijuan Wang, Huaman Liu and Rong He

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Oncotarget. 2017; 8:78044-78056. https://doi.org/10.18632/oncotarget.20351

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Xinyue Zhang1, Ning Jiang2, Lijuan Wang3, Huaman Liu4 and Rong He3

1Department of Lung Disease, The First Clinic Medical College, Shandong Traditional Chinese Medicine University, Jinan, Shandong Province, China

2Department of Traditional Chinese Medicine, Maternal and Child Health Care of Shandong Province, Key Laboratory of Birth Regulation and Control Technology of National Health Family Planning Commission of China, Jinan, Shandong Province, China

3Department of Lung Disease, The Affiliated Hospital of Shandong Traditional Chinese Medicine University, Jinan, Shandong Province, China

4Department of Internal Medicine, The Affiliated Hospital of Shandong Traditional Chinese Medicine University, Jinan, Shandong Province, China

Correspondence to:

Ning Jiang, email: [email protected]

Keywords: chronic obstructive pulmonary disease, lung cancer, meta-analysis, relative risk

Received: April 19, 2017    Accepted: July 25, 2017    Published: August 18, 2017


Background: Studies exploring the association between chronic obstructive pulmonary disease (COPD) and lung cancer have yielded mixed results. We conducted a meta-analysis of the published prospective cohort studies to have a clear understanding about this association.

Methods: We searched the MEDLINE and EMBASE databases from inception to December 31, 2016. Bibliographies were also reviewed for additional information. Random-effects model was used to calculate summary relative risk (SRR) and corresponding 95% confidence interval (CI).

Results: Eighteen prospective cohort studies were part of this meta-analysis, involving 12,442 lung cancer cases with a median duration of follow- up of 5 years (range: 1.5–20 years). A history of COPD, emphysema or chronic bronchitis conferred SRRs of 2.06 (95% CIs: 1.50-2.85; n=14 studies), 2.33 (95% CIs: 1.56–3.49; n=4 studies) and 1.17 (95%CIs: 0.79–1.73; n=3 studies), respectively. Stratification by COPD severity yielded SRR of 1.46 (95% CIs: 1.20–1.76) for mild, 2.05 (95% CIs: 1.67-2.52) for moderate and 2.44(95% CIs: 1.73-3.45) for severe COPD, respectively. There were similar risk estimations for never and ever smokers. The SRR was statistically higher for squamous cell cancer than that for adenocarcinoma and for small cell cancer of the lung (P<0.05).

Conclusion: This meta-analysis indicated a significantly increased risk of lung cancer for COPD, emphysema, but not for chronic bronchitis. For the prevention of lung cancer, it is of importance for early detection of COPD in lung cancer surveillance.

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