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Communications to the Editor |

Risk of Cancers in COPD Patients FREE TO VIEW

Mika Nakayama; Hiroaki Satoh; Kiyohisa Sekizawa
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Institute of Clinical Medicine, University of Tsukuba Ibaraki, Japan

Correspondence to: Hiroaki Satoh, MD, Division of Respiratory Medicine, Institute of Clinical Medicine, University of Tsukuba, Tsukuba-city, Ibaraki, 305-8575, Japan; e-mail: hirosato@md. tsukuba.ac.jp



Chest. 2003;123(5):1775-1776. doi:10.1378/chest.123.5.1775-a
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To the Editor:

Patients with COPD often experience peptic ulcers, sleep problems, and depressive disorders.13 However, it is not clear whether COPD patients have a higher incidence of cancers originating from the lung or other organs. To ascertain the risk, we investigated the incidence of cancers in 127 patients in whom COPD had been diagnosed in our hospital between 1996 and 2002. The diagnosis of COPD was based on medical history and the results of pulmonary function tests, which confirmed the presence of severe irreversible bronchial obstruction (ie, FEV1, < 1.5 L or < 70% of predicted), hyperinflation (total lung capacity, > 100% of predicted), and reduced diffusing capacity of the lung for carbon monoxide (ie, < 70% of predicted).4 We compared these patients with 140 age-matched, sex-matched, and smoking history-matched patients who had benign respiratory disease (128 men; median age, 71 years) diagnosed during the period. The median age of 127 COPD patients was 72 years, and 115 were men. Among them, 23 metachronous cancers and 22 synchronous cancers were found in 34 patients with COPD. On the other hand, 19 of 140 control subjects had a medical history of cancer. The relative risk of cancer occurring in COPD patients compared with control subjects was 2.32 (95% confidence interval, 1.24 to 4.27; p = 0.0069). The most common cancers in COPD patients were those of the lung (18 cancers), the head and neck (15 cancers), and the urinary tract (6 cancers). Nineteen cancers in 34 COPD patients, whose lesions were detected at an early stage, were treated successfully.

Patients with COPD seem to have a high incidence of lung cancer,4 however, little attention has been given to the incidence of cancers originating in other organs. In the present study, we compared COPD patients with age-matched, sex-matched, and smoking history-matched control subjects, and found possible evidence that COPD patients have a higher incidence of cancer. Although smoking is a major cause of COPD and certain cancers, other risk factors may play certain roles in developing cancers in COPD patients. Cancers of the aerodigestive tract and lung were the most common in the patients in our study. Moreover, not a few cancers in COPD patients were detected at an early stage, were treated properly, and were cured. Therefore, physicians should be alert to the development of malignancies in COPD patients in order to detect them at an early stage and administer proper treatment.

References

Kroeker, EJ (1966) Pulmonary emphysema and peptic ulcer.Med Clin North Am50,479-486
 
George, CF Perspectives on the management of insomnia in patients with chronic respiratory disorders.Sleep2000;23(suppl),S31-S35
 
van Manen, JG, Bindels, PJ, Dekker, FW, et al Risk of depression in patients with chronic obstructive pulmonary disease and its determinants.Thorax2002;57,412-416
 
Kurishima, K, Satoh, H, Ishikawa, H, et al Lung cancer patients with chronic obstructive pulmonary disease.Oncol Rep2001;8,63-65
 

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References

Kroeker, EJ (1966) Pulmonary emphysema and peptic ulcer.Med Clin North Am50,479-486
 
George, CF Perspectives on the management of insomnia in patients with chronic respiratory disorders.Sleep2000;23(suppl),S31-S35
 
van Manen, JG, Bindels, PJ, Dekker, FW, et al Risk of depression in patients with chronic obstructive pulmonary disease and its determinants.Thorax2002;57,412-416
 
Kurishima, K, Satoh, H, Ishikawa, H, et al Lung cancer patients with chronic obstructive pulmonary disease.Oncol Rep2001;8,63-65
 
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