 |
 |

Lung Cancer Risk Following Detection of Pulmonary Scarring by Chest Radiography in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial
Ying-Ying Yu, PhD;
Paul F. Pinsky, PhD;
Neil E. Caporaso, MD;
Nilanjan Chatterjee, PhD;
Mona Baumgarten, PhD;
Patricia Langenberg, PhD;
Jon P. Furuno, PhD;
Qing Lan, MD, PhD;
Eric A. Engels, MD
Arch Intern Med. 2008;168(21):2326-2332.
Background Fibrotic scars are frequently found in proximity to lung cancer at the time of cancer diagnosis. However, the nature of the relationship between pulmonary scarring and lung cancer remains uncertain. Our objective was to test whether localized pulmonary scarring is associated with increased lung cancer risk.
Methods Cohort analysis of data from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. We included 66 863 cancer-free trial participants aged 55 to 74 years, who received a baseline chest radiographic examination and were followed up subsequently for up to 12 years. We used proportional hazards models to estimate hazard ratios (HRs) for lung cancer associated with scarring, adjusting for age, sex, race, and cigarette smoking, and in relation to laterality of scarring. The main outcome measure was incident lung cancer.
Results Scarring was present on the baseline chest radiograph for 5041 subjects (7.5%). Scarring was associated with elevated lung cancer risk (809 lung cancer cases [HR, 1.5; 95% confidence interval {CI}, 1.2-1.8]). This association was specific for cancer in the lung ipsilateral to the scar (HR, 1.8; 95% CI, 1.4-2.4) and absent for contralateral cancer (HR, 0.9; 95% CI, 0.7-1.2). Ipsilateral lung cancer risk was elevated throughout the follow-up period (interval-specific HRs, 1.6, 2.0, 2.1, and 1.7 during 0.01-2.00, 2.01-4.00, 4.01-6.00, and 6.01-12.00 years after baseline chest radiography, respectively).
Conclusions The relationship between pulmonary scarring and lung cancer was specific to the same lung and extended over time. These findings are consistent with the hypothesis that localized inflammatory processes associated with scarring promote the subsequent development of lung cancer.
Author Affiliations: Divisions of Cancer Epidemiology and Genetics (Drs Yu, Caporaso, Chatterjee, Lan, and Engels) and Cancer Prevention (Dr Pinsky), National Cancer Institute, National Institutes of Health, Rockville, Maryland; and Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore (Drs Yu, Baumgarten, Langenberg, and Furuno).
CiteULike Connotea Delicious Digg Facebook Reddit Technorati Twitter
What's this?
RELATED ARTICLES
In This Issue of Archives of Internal Medicine
Arch Intern Med. 2008;168(21):2300.
FULL TEXT
Lung Cancer Risk Following Detection of Pulmonary Scarring by Chest Radiography in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial—Invited Commentary
Sigmund A. Weitzman
Arch Intern Med. 2008;168(21):2332.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
 |
Effect of ageing and pulmonary inflammation on the incidence and number of cross-bridging structures in pneumothorax patients
Sasaki et al.
Acta Radiol 2011;52:1088-1094.
ABSTRACT
| FULL TEXT
Circulating Markers of Interstitial Lung Disease and Subsequent Risk of Lung Cancer
Shiels et al.
Cancer Epidemiol. Biomarkers Prev. 2011;20:2262-2272.
ABSTRACT
| FULL TEXT
Increased Risk of Lung Cancer in Men with Tuberculosis in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study
Shiels et al.
Cancer Epidemiol. Biomarkers Prev. 2011;20:672-678.
ABSTRACT
| FULL TEXT
Old cavity, new cancer - is it time to re-think?
Karia et al.
J R Soc Med Sh Rep 2011;2:18-18.
FULL TEXT
C-Reactive Protein and Risk of Lung Cancer
Chaturvedi et al.
JCO 2010;28:2719-2726.
ABSTRACT
| FULL TEXT
Clinical features of primary lung cancer adjoining pulmonary bulla
Kaneda et al.
Interact CardioVasc Thorac Surg 2010;10:940-944.
ABSTRACT
| FULL TEXT
|