Journal
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
Volume 190, Issue 5, Pages 549-559Publisher
AMER THORACIC SOC
DOI: 10.1164/rccm.201402-0338OC
Keywords
epidemiologic study; lung neoplasm; pulmonary disease; data pooling; case-control study
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Funding
- Institut National du Cancer in France
- German Social Accident Insurance (DGUV)
- Canadian Institutes for Health Research
- Guzzo-SRC Chair in Environment and Cancer
- National Cancer Institute of Canada
- Canadian Cancer Society
- Workplace Safety and Insurance Board
- Cancer Care Ontario
- French Agency of Health Security (ANSES)
- Fondation de France
- French National Research Agency (ANR)
- National Institute of Cancer (INCA)
- Foundation for Medical Research (FRM)
- French Institute for Public Health Surveillance (InVS)
- Health Ministry (DGS)
- Organization for the Research on Cancer (ARC)
- French Ministry of Work, Solidarity, and Public Function (DGT)
- Federal Ministry of Education, Science, Research, and Technology [01 HK 173/0]
- Federal Ministry of Science [01 HK 546/8]
- Ministry of Labor and Social Affairs [IIIb7-27/13]
- European Commission [IC15-CT96-0313]
- Polish State Committee for Scientific Research [SPUB-M-COPERNICUS/P-05/DZ-30/99/2000]
- Roy Castle Lung Cancer Foundation
- Intramural Research Program of the National Institutes of Health, National Cancer Institute, Division of Cancer Epidemiology and Genetics (Bethesda, MD)
- Environmental Epidemiology Program of the Lombardy Region, Italy
- Istituto Nazionale per l'Assicurazione contro gli Infortuni sul Lavoro (Rome, Italy)
- National Institute for Health Research [CL-2013-21-011] Funding Source: researchfish
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Rationale: Previous respiratory diseases have been associated with increased risk of lung cancer. Respiratory conditions often co-occur and few studies have investigated multiple conditions simultaneously. Objectives: Investigate lung cancer risk associated with chronic bronchitis, emphysema, tuberculosis, pneumonia, and asthma. Methods: The SYNERGY project pooled information on previous respiratory diseases from 12,739 case subjects and 14,945 control subjects from 7 case-control studies conducted in Europe and Canada. Multivariate logistic regression models were used to investigate the relationship between individual diseases adjusting for co-occurring conditions, and patterns of respiratory disease diagnoses and lung cancer. Analyses were stratified by sex, and adjusted for age, center, ever-employed in a high-risk occupation, education, smoking status, cigarette pack-years, and time since quitting smoking. Measurements and Main Results: Chronic bronchitis and emphysema were positively associated with lung cancer, after accounting for other respiratory diseases and smoking (e.g., in men: odds ratio [On 1.33; 95% confidence interval [CI], 1.20-1.48 and OR, 1.50; 95% CI, 1.21-1.87, respectively). A positive relationship was observed between. lung cancer and pneumonia diagnosed 2 years or less before lung cancer (OR, 3.31; 95% CI, 2.33-4.70 for men), but not longer. Co-occurrence of chronic bronchitis and emphysema and/or pneumonia had a stronger positive association with lung cancer than chronic bronchitis only. Asthma had an inverse association with lung cancer, the association being stronger with an asthma diagnosis 5 years or more before lung cancer compared with shorter. Conclusions: Findings from this large international case-control consortium indicate that after accounting for co-occurring respiratory diseases, chronic bronchitis and emphysema continue to have a positive association with lung cancer. Keywords: epidemiologic study; lung neoplasm; pulmonary disease; data pooling; case-control study
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