Patients with COPD often experience peptic ulcers, sleep problems, and depressive disorders.1–3
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.