Cross-sectional study of lung cancer patients as a potential high-risk factor for abdominal aortic aneurysm

Abstract

Background: Abdominal aortic aneurysm (AAA) is more common in Non-small cell lung cancer (NSCLC) patients. Considering that ruptured AAA is potentially fatal, timely management of AAA would result in long-term survival benefits. We assess the prevalence and characteristics of AAA in resectable NSCLC patients who would benefit from AAA surveillance.

Methods: 1,019 resectable NSCLC patients in Severance and Kangbuk Samsung Hospitals were reviewed from January 2019 to November 2020. The control group comprised 2,899 cancer-free people who had a health check-up CT scan in Severance between January 2018 and December 2019.

Results: Among resectable primary NSCLC patients, 39/1,019 (3.8%; odds ratio [OR], 19.19; 95% confidence interval [CI], 8.10-46.46) had AAA compared with 6/2,899 (0.2%) in the control (P<0.001). In multivariable regression analysis, male (OR, 13.24; 95% CI, 1.50-117.48; P = 0.020), aging (OR, 1.10; 95% CI, 1.04-1.15; P<0.001), current smoker (OR, 4.20; 95% CI, 1.20-14.62; P = 0.024), and coronary artery disease (OR, 3.13; 95% CI, 1.48-6.62; P = 0.003) were independent risk factors for AAA in NSCLC.

Conclusion: The present study found that the incidence of AAA in resectable early-stage lung cancer patients was significantly higher than in the cancer-free control group. Therefore, we suggest that early-stage NSCLC patients, especially smokers older than 60 years, undergo regular AAA surveillance as part of their lung cancer monitoring.