Reduced Expiratory Flow Rate among Heavy Smokers Increases Lung Cancer Risk. Results from the National Lung Screening Trial–American College of Radiology Imaging Network Cohort

• DOI: 10.1513/annalsats.201609-741oc
• Publication Date: 2017-03-01T20:21:06Z
• Authors: Raewyn J. Hopkins; Fenghai Duan; Caroline Chiles; Erin M. Greco; Greg D. Gamble; Denise Aberle; Robert P. Young
• Keywords: Obstructive lung disease

Although epidemiological studies consistently show that chronic obstructive pulmonary disease is associated with an increased risk of lung cancer, debate exists as to whether there a linear relationship between the severity airflow limitation and cancer risk.We examined this in large, prospective study older heavy smokers from American College Radiology Imaging Network subcohort National Lung Screening Trial (ACRIN). Airflow was defined by prebronchodilator spirometry subgrouped according Global Initiative for Chronic Obstructive Disease (GOLD) grades 1-4.In Trial-ACRIN cohort 18,473 screening participants, 6,436 had (35%) 12,037 (65%) no limitation. From these groups, 758 cases were prospectively identified. Participants stratified GOLD groups 1 (n = 1,607), 2 3,528), 3 1,083), 4 211). incidence at end (mean follow-up, 6.4 yr) compared those (referent group).Compared limitation, where 3.78/1,000 person years, rates simple relationship: (6.27/1,000 yr); (7.86/1,000 (10.71/1,000 (13.25/1,000 yr). All relationships significant versus reference group P value 0.0001 or less.In large high-risk cigarette smokers, we report strong increasing cancer.