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. 2020 Dec 17;56(6):1902154.
doi: 10.1183/13993003.02154-2019. Print 2020 Dec.

The associations of interstitial lung abnormalities with cancer diagnoses and mortality

Gisli T Axelsson  1 , Rachel K Putman  2 , Thor Aspelund  3   4 , Elias F Gudmundsson  4 , Tomayuki Hida  5   6 , Tetsuro Araki  5   6 , Mizuki Nishino  5   6 , Hiroto Hatabu  5   6 , Vilmundur Gudnason  3   4 , Gary M Hunninghake  2   6 , Gunnar Gudmundsson  3   7
Affiliations

The associations of interstitial lung abnormalities with cancer diagnoses and mortality

Gisli T Axelsson et al. Eur Respir J. .

Abstract

An increased incidence of lung cancer is well known among patients with idiopathic pulmonary fibrosis. It is not known whether interstitial lung abnormalities, i.e. early fibrotic changes of the lung, are a risk factor for lung cancer in the general population.The study's objective was to assess whether interstitial lung abnormalities were associated with diagnoses of, and mortality from, lung cancer and other cancers. Data from the AGES-Reykjavik study, a cohort of 5764 older Icelandic adults, were used. Outcome data were ascertained from electronic medical records. Gray's tests, Cox proportional hazards models and proportional subdistribution hazards models were used to analyse associations of interstitial lung abnormalities with lung cancer diagnoses and lung cancer mortality as well as diagnoses and mortality from all cancers.There was a greater cumulative incidence of lung cancer diagnoses (p<0.001) and lung cancer mortality (p<0.001) in participants with interstitial lung abnormalities than in others. Interstitial lung abnormalities were associated with an increased hazard of lung cancer diagnosis (hazard ratio 2.77) and lung cancer mortality (hazard ratio 2.89) in adjusted Cox models. Associations of interstitial lung abnormalities with all cancers were found in models including lung cancers but not in models excluding lung cancers.People with interstitial lung abnormalities are at increased risk of lung cancer and lung cancer mortality, but not of other cancers. This implies that an association between fibrotic and neoplastic diseases of the lung exists from the early stages of lung fibrosis and suggests that interstitial lung abnormalities could be considered as a risk factor in lung cancer screening efforts.

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Conflict of interest statement

Conflict of interest: G.T. Axelsson has nothing to disclose. Conflict of interest: R.K. Putman reports grants from NIH, during the conduct of the study. Conflict of interest: T. Aspelund has nothing to disclose. Conflict of interest: E.F. Gudmundsson has nothing to disclose. Conflict of interest: T. Hida has nothing to disclose. Conflict of interest: T. Araki has nothing to disclose. Conflict of interest: M. Nishino reports personal fees for consultancy from Daiichi Sankyo and AstraZeneca; honoraria from Roche; and grants from Merck, AstraZeneca, Canon Medical Systems and NIH (R01CA203636, U01CA209414, R01HL111024), outside the submitted work. Conflict of interest: H. Hatabu reports grants from Canon Medical System Inc. and Konica-Minolta Inc., personal fees for consultancy from Mitsubishi Chemical Inc. and personal fees for advisory board work from Canon Medical System Inc., outside the submitted work. Conflict of interest: V. Gudnason has nothing to disclose. Conflict of interest: G.M. Hunninghake reports personal fees from Genentech, Boehringer Ingelheim, The Gerson Lehrman Group and Mitsubishi Chemical, outside the submitted work. Conflict of interest: G. Gudmundsson has nothing to disclose.

Figures

Figure 1 -
Figure 1 -. Cumulative incidence of cancer diagnoses among participants with and without ILA
P-values are for differences in the cumulative incidence of cancer diagnoses between participants with interstitial lung abnormalities and participants without interstitial lung abnormalities using Gray’s tests.
Figure 2 -
Figure 2 -. Cumulative incidence of cancer mortality among participants with and without ILA
P-values are for differences in the cumulative incidence of mortality due to the specified cause between participants with interstitial lung abnormalities and participants without interstitial lung abnormalities using Gray’s tests.
See this image and copyright information in PMC

References

    1. Washko GR, Hunninghake GM, Fernandez IE, Nishino M, Okajima Y, Yamashiro T, Ross JC, Estepar RS, Lynch DA, Brehm JM, Andriole KP, Diaz AA, Khorasani R, D’Aco K, Sciurba FC, Silverman EK, Hatabu H, Rosas IO. Lung volumes and emphysema in smokers with interstitial lung abnormalities. N Engl J Med 2011: 364(10): 897–9l06. - PMC - PubMed
    1. Araki T, Putman RK, Hatabu H, Gao W, Dupuis J, Latourelle JC, Nishino M, Zazueta OE, Kurugol S, Ross JC, San Jose Estepar R, Schwartz DA, Rosas IO, Washko GR, O’Connor GT, Hunninghake GM. Development and Progression of Interstitial Lung Abnormalities in the Framingham Heart Study. Am J Respir Crit Care Med 2016: 194(12): 1514–152l2. - PMC - PubMed
    1. Putman RK, Gudmundsson G, Axelsson GT, Hida T, Honda O, Araki T, Yanagawa M, Nishino M, Miller ER, Eiriksdottir G, Gudmundsson EF, Tomiyama N, Honda H, Rosas IO, Washko GR, Cho MH, Schwartz DA, Gudnason V, Hatabu H, Hunninghake GM. Imaging Patterns are Associated with Interstitial Lung Abnormality Progression and Mortality. Am J Respir Crit Care Med 2019. - PMC - PubMed
    1. Hunninghake GM, Hatabu H, Okajima Y, Gao W, Dupuis J, Latourelle JC, Nishino M, Araki T, Zazueta OE, Kurugol S, Ross JC, San Jose Estepar R, Murphy E, Steele MP, Loyd JE, Schwarz MI, Fingerlin TE, Rosas IO, Washko GR, O’Connor GT, Schwartz DA. MUC5B promoter polymorphism and interstitial lung abnormalities. N Engl J Med 2013: 368(23): 2192–22l00. - PMC - PubMed
    1. Hobbs BD, Putman RK, Araki T, Nishino M, Gudmundsson G, Gudnason V, Eiriksdottir G, Zilhao Nogueira NR, Dupuis J, Xu H, O’Connor GT, Manichaikul A, Nguyen J, Podolanczuk AJ, Madahar P, Rotter JI, Lederer DJ, Barr RG, Rich SS, Ampleford EJ, Ortega VE, Peters SP, O’Neal WK, Newell JD Jr.,Bleecker ER, Meyers DA, Allen RJ, Oldham JM, Ma SF, Noth I, Jenkins RG, Maher TM, Hubbard RB, Wain LV, Fingerlin TE, Schwartz DA, Washko GR, Rosas IO, Silverman EK, Hatabu H, Cho MH, Hunninghake GM. Overlap of Genetic Risk between Interstitial Lung Abnormalities and Idiopathic Pulmonary Fibrosis. Am J Respir Crit Care Med 2019: 200(11): 1402–141l3. - PMC - PubMed

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