한빛사 논문
Hye Yun Park,1 Danbee Kang,2,3 Sun Hye Shin,1 Kwang-Ha Yoo,4 Chin Kook Rhee,5 Gee Young Suh,1 Hojoong Kim,1 Young Mog Shim,6 Eliseo Guallar,7 Juhee Cho,2,3,7,* O Jung Kwon1,*
1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
2Center for Clinical Epidemiology, Samsung Medical Center, Seoul, South Korea
3Department of Clinical Research and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
4Department of Internal Medicine, Konkuk University School of Medicine, Seoul, South Korea
5Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
6Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
7Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
*Corresponding author
HYP and DK contributed equally.
JC and OJK contributed equally.
Abstract
There has been limited evidence for the association between chronic obstructive pulmonary disease (COPD) and the incidence of lung cancer among never smokers. We aimed to estimate the risk of lung cancer incidence in never smokers with COPD, and to compare it with the risk associated with smoking. This cohort study involved 338 548 subjects, 40 to 84 years of age with no history of lung cancer at baseline, enrolled in the National Health Insurance Service National Sample Cohort. During 2 355 005 person-years of follow-up (median follow-up 7.0 years), 1834 participants developed lung cancer. Compared with never smokers without COPD, the fullyadjusted hazard ratios (95%CI) for lung cancer in never smokers with COPD, ever smokers without COPD, and ever smokers with COPD were 2.67 (2.09 to 3.40), 1.97 (1.75 to 2.21), and 6.19 (5.04 to 7.61), respectively. In this large national cohort study, COPD was also a strong independent risk factor for lung cancer incidence in never smokers, implying that COPD patients are at high risk of lung cancer, irrespective of smoking status.
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