Chest
Original Research: Lung CancerPrevalence of COPD in Women Compared to Men Around the Time of Diagnosis of Primary Lung Cancer
Section snippets
Materials and Methods
All patients in whom primary lung cancer was diagnosed at Memorial Sloan-Kettering Cancer Center (MSKCC) between March 1995 and January 1997 and who had undergone PFTs prior to their treatment were included in the study. The interpretation of the PFT results was based on the guidelines of the American Thoracic Society (ATS).11 Patients were considered to have COPD when the FEV1/FVC ratio was < 70%.
When PFTs were performed at MSKCC, measurements were made from spirometry (GS Pulmonary Module
Results
During the study period, primary lung cancer was diagnosed in 436 patients. Of these, 294 patients (67%) had undergone PFTs prior to receiving treatment and were included in the study. The median time from the date of the PFTs to the diagnosis of lung cancer in the study was 0.1 month (range, −3.8 to 10.7 months). In 78%, 18%, 3%, and 1% of patients, respectively, PFTs were performed 1 month, 1 to 3 months, 3 to 6 months, and > 6 months from the date of lung cancer diagnosis. There was no
Discussion
The results of this study show that at or around the time of lung cancer diagnosis, fewer women were noted to have spirometric evidence of airflow obstruction compared to men. When adjusted for age and smoking history, there remained a significantly lower proportion of women with COPD. These data suggest (although they do not prove) that the prevalence of COPD in lung cancer patients may be different in women compared to men. The findings from this study supplement results from the literature,2
Conclusion
Around the time of the lung cancer diagnosis, a significantly lower proportion of women showed evidence of airways obstruction on spirometry compared to men. Based on this information, gender-based differences in spirometry should be considered when constructing strategies for the screening for lung cancer. Future studies should prospectively examine the prevalence of airflow obstruction in a gender-matched population with and without lung cancer. The understanding of gender-based risk factors
References (38)
Revisions in the International System for Staging Lung Cancer
Chest
(1997)Bronchogenic Carcinoma Co-operative Group. Comorbidity in operable lung cancer: a multicenter descriptive study of 2992 patients
Lung Cancer
(2002)- et al.
Incidence of airflow obstruction in bronchial carcinoma, its relation to breathlessness and response to bronchodilator therapy
Respir Med
(1995) Lung cancer and chronic obstructive pulmonary disease
Hematol Oncol Clin North Am
(1997)- et al.
The relationship between lung cancer and chronic bronchitis
Br J Dis Chest
(1963) - et al.
The Philadelphia Pulmonary Neoplasm Research Project: the risk of lung cancer in relation to symptoms and roentgenographic abnormalities
Environ Res
(1977) Recent trends in mortality rates for four major cancers, by sex and race/ ethnicity: United States, 1990 to 1998
JAMA
(2002)- et al.
Differences in lung cancer risk between men and women: examination of the evidence
J Natl Cancer Inst
(1996) - et al.
p53 mutations in lung tumors: relationship to gender and DNA adduct levels
Carcinogenesis
(1996) - et al.
Sex-specific expression of gastrin-releasing peptide receptor: relationship of smoking history and risk of lung cancer
J Natl Cancer Inst
(2000)
Lung cancer risk for female smokers
Science
Sex and gender differences in lung cancer
J Gend Specif Med
Higher risk of lung cancer in COPD: a prospective randomized matched controlled study
Ann Intern Med
Airways obstruction and the risk for lung cancer
Ann Intern Med
Relation of forced expiratory volume (FEV-1) to lung cancer mortality in the Multiple Risk Factor Intervention Trial (MRFIT)
Am J Epidemiol
Prospective study of pulmonary function and lung cancer
Am Rev Respir Dis
American Thoracic Society. Standardization of spirometry: 1994 update
Am J Respir Crit Care Med
Reference spirometric values using techniques and equipment that meet ATS recommendations
Am Rev Respir Dis
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