Article

Relationship between reduced forced expiratory volume in one second and the risk of lung cancer: A systematic review and meta-analysis

Department of Medicine(Respiratory Division), University of Bristish Columbia and The James Hogg iCAPTURE Center for Cardiovascular and Pulmonary Research, St Paul's Hospital, Room #368A, 1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6.
Thorax (Impact Factor: 8.29). 07/2005; 60(7):570-5. DOI: 10.1136/thx.2004.037135
Source: PubMed

ABSTRACT

Individuals with severely impaired lung function have an increased risk of lung cancer. Whether milder reductions in forced expiratory volume in 1 second (FEV(1)) also increase the risk of lung cancer is controversial. Moreover, there is little consensus on whether men and women have similar risks for lung cancer for similar decreases in FEV(1).
A search was conducted of PubMed and EMBASE from January 1966 to January 2005 and studies that examined the relationship between FEV1 and lung cancer were identified. The search was limited to studies that were population based, employed a prospective design, were large in size (> or = 5000 participants), and adjusted for cigarette smoking status.
Twenty eight abstracts were identified, six of which did not report FEV1 and eight did not adjust for smoking. Included in this report are four studies that reported FEV1 in quintiles. The risk of lung cancer increased with decreasing FEV1. Compared with the highest quintile of FEV1 (> 100% of predicted), the lowest quintile of FEV1 (< approximately 70% of predicted) was associated with a 2.23 fold (95% confidence interval (CI) 1.73 to 2.86) increase in the risk for lung cancer in men and a 3.97 fold increase in women (95% CI 1.93 to 8.25). Even relatively small decrements in FEV1 ( approximately 90% of predicted) increased the risk for lung cancer by 30% in men (95% CI 1.05 to 1.62) and 2.64 fold in women (95% CI 1.30 to 5.31).
Reduced FEV1 is strongly associated with lung cancer. Even a relatively modest reduction in FEV1 is a significant predictor of lung cancer, especially among women.

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Available from: Wen Qi Gan, Dec 13, 2013
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    • "The enrolled cohort had a high fraction of COPD based on PFT criteria. This is important because COPD is an independent risk factor for lung cancer303132333435363738. Notably , using PFT data (FEV1/FVC <0.7) as the diagnostic criterion, one-third of individuals in this study misclassified their COPD status on the enrollment survey selfreport . "
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    Full-text · Article · Feb 2013 · BMC Cancer
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    • "[1-10]). However, apart from a review in 2005 by Wasswa-Kintu et al.[11] we are unaware of any previous attempt to meta-analyse the available data, and that review restricted its meta-analysis only to those four studies which reported results by quintiles of FEV1, although noting the existence of data from a larger number of studies. In order to obtain a more precise estimate of the relationship of FEV1 to lung cancer risk, and to study factors which might affect the strength of this relationship, this systematic review and meta-analysis combines separate quantitative estimates of the relationship from studies which have presented their findings in a variety of ways. "
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