The association between combined non-cystic fibrosis bronchiectasis and lung cancer in patients with chronic obstructive lung disease

Int J Chron Obstruct Pulmon Dis. 2015 May 4;10:873-9. doi: 10.2147/COPD.S80439. eCollection 2015.


Background: Whereas the epidemiological association between lung cancer and chronic obstructive pulmonary disease (COPD), a chronic inflammatory respiratory disease, is well known, limited studies have examined the association between lung cancer and non-cystic fibrosis bronchiectasis, a representative chronic airway inflammatory disease. This study evaluated the association between bronchiectasis and lung cancer in patients with COPD.

Methods: A matched case-control study was conducted in a referral hospital in South Korea. Among COPD patients with moderate to very severe airflow limitation (forced expiratory volume in one second/forced vital capacity <0.7 and forced expiratory volume in one second ≤70% [% predicted]) who underwent chest computed tomography (CT) between January 1, 2010 and May 30, 2013, patients with lung cancer and controls matched for age, sex, and smoking history were selected. The risk of lung cancer was assessed according to the presence of underlying bronchiectasis confirmed by chest CT.

Results: The study enrolled 99 cases and 198 controls. Combined bronchiectasis on chest CT was inversely associated with the risk of lung cancer compared with controls (odds ratio [OR] 0.25, 95% confidence interval [CI] 0.12-0.52, P<0.001). Significant associations were found in patients with squamous cell carcinoma (OR 0.11, 95% CI 0.03-0.49, P=0.001) and history of smoking (OR 0.27, 95% CI 0.12-0.57, P<0.001). However, the severity and location of bronchiectasis were not associated with the risk of lung cancer.

Conclusion: Interestingly, the concomitant presence of bronchiectasis in COPD patients was associated with a lower risk of lung cancer.

Keywords: COPD; bronchiectasis; chronic inflammation; lung cancer.

MeSH terms

  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / epidemiology*
  • Adenocarcinoma / physiopathology
  • Adenocarcinoma of Lung
  • Aged
  • Bronchiectasis / diagnostic imaging
  • Bronchiectasis / epidemiology*
  • Bronchiectasis / physiopathology
  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging
  • Carcinoma, Non-Small-Cell Lung / epidemiology*
  • Carcinoma, Non-Small-Cell Lung / physiopathology
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / epidemiology*
  • Carcinoma, Squamous Cell / physiopathology
  • Case-Control Studies
  • Comorbidity
  • Female
  • Forced Expiratory Volume
  • Humans
  • Lung / physiopathology
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / epidemiology*
  • Lung Neoplasms / physiopathology
  • Male
  • Middle Aged
  • Odds Ratio
  • Predictive Value of Tests
  • Pulmonary Disease, Chronic Obstructive / diagnostic imaging
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Republic of Korea / epidemiology
  • Risk Factors
  • Severity of Illness Index
  • Small Cell Lung Carcinoma / diagnostic imaging
  • Small Cell Lung Carcinoma / epidemiology*
  • Small Cell Lung Carcinoma / physiopathology
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Tomography, X-Ray Computed
  • Vital Capacity