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Effect of pre existing respiratory conditions on survival of lung cancer patients: A nationwide population-based cohort study

 Seri Hong  ;  Eun-Cheol Park  ;  Tae Hyun Kim  ;  Jeoung A Kwon  ;  Ki-Bong Yoo  ;  Kyu-Tae Han  ;  Ji Won Yoo  ;  Sun Jung Kim 
 Asia-Pacific Journal of Clinical Oncology, Vol.14(2) : e71-e80, 2018 
Journal Title
 Asia-Pacific Journal of Clinical Oncology 
Issue Date
Adult ; Aged ; 80 and over Aged ; Asthma/*complications/pathology ; Female ; Humans ; Lung Neoplasms/*etiology/mortality ; Male ; Middle Aged ; Prognosis ; Chronic Obstructive/*complications/pathology Pulmonary Disease ; Retrospective Studies ; Risk Factors ; Survival Analysis ; Young Adult
lung neoplasms ; pre-existing condition ; respiratory tract diseases ; survival
BACKGROUND: Common diseases with potential to increase the risk of death from lung cancer have so far not been studied in large populations. METHODS: We did a population-based retrospective cohort study using nationwide health insurance claims data from 2005 to 2012 in Korea including 205 403 lung cancer patients. Multivariate-adjusted hazard ratios (aHRs) of lung cancer mortality by presence, time intervals with lung cancer diagnosis and combinations of pre-existing chronic obstructive pulmonary disease (COPD), pneumonia, asthma and tuberculosis were calculated using the Cox-proportional hazards model. RESULTS: The total number of person-years of follow-up was 397 780 and 60.2% of patients died (mean survival 23.2 months after lung cancer diagnosis). Lung cancer patients with previous respiratory disease had increased aHR for mortality (COPD, hazard ratio [HR] = 1.32, CI 1.29-1.35; pneumonia, HR = 1.14, CI 1.08-1.19; and asthma, HR = 1.11, CI 1.06-1.16). Risks were positively associated with longer duration of pre-existing disease diagnosis; cases with >5 years since diagnosis compared to <2 years: COPD, HR = 2.91, CI 2.82-3.00; pneumonia, HR = 1.67, CI 1.51-1.85; asthma, HR = 1.56, CI 1.45-1.68; and tuberculosis, HR = 2.03, CI 1.90-2.17. Furthermore, elevated HRs of death were found among patients with multiple pre-existing co-morbidities. CONCLUSION: Hazards of death from lung cancer are significantly increased in cases with pre-existing lung disease, and worse with longer durations, and with multiple combinations before cancer diagnosis. Patients and physicians should be aware of these meaningful risk/prognostic factors for lung cancer when identifying high-risk patient groups.
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4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hyun(김태현) ORCID logo https://orcid.org/0000-0003-1053-8958
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
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