Background: Low-grade systemic inflammation is considered a hallmark of chronic obstructive pulmonary disease (COPD) that potentially links COPD to increased cancer risk. However relationship between COPD and cancer remains controversial. The main purpose of this study was to assess the relationship between COPD and all-cause cancer among adult smokers in a nested case-control study.

Methods: The study used the 2018 Behavioral Risk Factor Surveillance System (BRFSS) dataset. Only individuals of 40 years and older who smoked at least 100 cigarettes in their lifetime were included into analysis. A nested case-control design has been employed with COPD as an exposure and cancer as an outcome. Cases with COPD were matched at 1:1 ratio with controls without COPD by age group, race, and sex using simple random sampling. Chi-square test was applied to determine whether the prevalence of cancer in the resulting groups was statistically significantly different. Conditional logistic regression was used to estimate the association between cancer and COPD after adjusting for covariates (education, income, BMI, marital, drinking and exercise status).

Results: Overall, 146,141 participants aged 40 or more who smoked at least 100 cigarettes in their entire lives were included into the study. 25,528 subjects with COPD were matched with non-COPD subjects by individual case-control matching at a 1:1 ratio. People who had COPD were more likely to report being diagnosed with cancer (OR=1.40, [95%CI, 1.32-1.48]) than non-COPD participants after adjusting for confounders. The result was similar in the original population (OR=1.39, [95%CI, 1.28-1.51]).

Conclusion: Our findings demonstrate that the diagnosis of COPD was significantly associated with cancer among smokers who aged more than 40 years old.

Citation Format: Joseph Finkelstein, Xingyue Huo. Chronic obstructive pulmonary disease as an independent risk factor for cancer [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4660.