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Review
. 2023 Feb 7;13(2):459.
doi: 10.3390/life13020459.

Do Patients with Bronchiectasis Have an Increased Risk of Developing Lung Cancer? A Systematic Review

Nadia Castaldo  1 , Alberto Fantin  1 , Massimiliano Manera  2 , Vincenzo Patruno  1 , Giulia Sartori  2 , Ernesto Crisafulli  2
Affiliations
Review

Do Patients with Bronchiectasis Have an Increased Risk of Developing Lung Cancer? A Systematic Review

Nadia Castaldo et al. Life (Basel). .

Abstract

Background: Initial evidence supports the hypothesis that patients with non-cystic fibrosis bronchiectasis (NCFB) have a higher risk of lung cancer. We systematically reviewed the available literature to define the characteristics of lung malignancies in patients with bronchiectasis and the characteristics of patients who develop bronchiectasis-associated lung cancer.

Method: This study was performed based on the PRISMA guidelines. The review protocol was registered in PROSPERO.

Results: The frequency rates of lung cancer in patients with NCFB ranged from 0.93% to 8.0%. The incidence rate was 3.96. Cancer more frequently occurred in the elderly and males. Three studies found an overall higher risk of developing lung cancer in the NCFB population compared to the non-bronchiectasis one, and adenocarcinoma was the most frequently reported histological type. The effect of the co-existence of NCFB and COPD was unclear.

Conclusions: NCFB is associated with a higher risk of developing lung cancer than individuals without NCFB. This risk is higher for males, the elderly, and smokers, whereas concomitant COPD's effect is unclear.

Keywords: COPD; bronchiectasis; hazard risk; lung cancer.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Bronchiectasis (25x): Low magnification shows a hyperectatic, distorted bronchial structure with flattening and focal ulceration of the surface epithelium, fibrosis of the stroma, and inhomogeneous depletion of the muscular and cartilaginous components. The pertinent artery shows thickening of the media suggestive of possible small circle pressure disorder. The bronchus is surrounded by cytoarchitecturally atypical glandulomorphic structures consistent with adenocarcinoma (acinar and lepidic pattern). The images have been provided free of charge by the Laboratory Department of Medical and Biological Science, Azienda Sanitaria Universitaria Integrata di Udine, Italy, and have been taken by Dr. Alessandro De Pellegrin.
Figure 2
Figure 2
Bronchiectasis and Lung adenocarcinoma (100x): Higher magnification highlights carcinomatous gland infiltration of the bronchial stroma, which shows chronic inflammatory infiltrates, dense fibrosis, and microcystic atrophy of the peribronchial glands; the surface epithelium is flattened and eroded. The images have been provided free of charge by the Laboratory Department of Medical and Biological Science, Azienda Sanitaria Universitaria Integrata di Udine, Italy, and have been taken by Dr. Alessandro De Pellegrin.
Figure 3
Figure 3
Emphysema and Lung adenocarcinoma (50x): Interface between lepidic pattern adenocarcinoma in sclero-elastotic stroma and parenchyma with emphysematous changes. The images have been provided free of charge by the Laboratory Department of Medical and Biological Science, Azienda Sanitaria Universitaria Integrata di Udine, Italy, and have been taken by Dr. Alessandro De Pellegrin.
Figure 4
Figure 4
Shows the complex relationship between NCFB and lung cancer.
See this image and copyright information in PMC

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