1284P - Lung cancer among patients with chronic obstructive pulmonary disease: A Danish 10-year observational study of the overlapping population

Background

Lung cancer (LC) is the leading cause of cancer-related death worldwide, and up to five times more likely to occur in smokers with chronic obstructive pulmonary disease (COPD) than those with normal lung function. In this study, we investigated the overlap between patients registered with COPD and patients examined on suspicion of LC over a 10-year period in the Region of Southern Denmark.

Methods

The National Registry of COPD and the Danish LC Registry delivered data on patients with COPD and LC respectively. The cohort referred for LC diagnostics was defined by assigned classification codes provided from the Health Care Classification System.

Results

During the study period, 25,647 patients were registered with COPD during hospitalizations, or from outpatient clinics. Among these, 5.030 patients (20%) were referred to LC diagnostics, and 1,551 were diagnosed with LC. This corresponds to a LC incidence of 6% among all patients with COPD, and 31% among COPD patients referred for LC diagnostics. COPD patients referred for LC diagnostics were generally more affected by COPD compared to the group of not referred for LC diagnostics. Referred patients collected more COPD related medication (6 of 7 medicaments), performed worse in terms of lung function (FEV1% 48% vs. 50%), suffered from a higher grade of dyspnea (71% vs. 57% MRC 3-5) and experiences a higher rate of exacerbations (42% vs. 31% with 2-3 exacerbations) compared to COPD patients not referred to LC diagnostics (p<0.05 for all). Among all patients who underwent LC diagnostics, COPD patients displayed a higher prevalence of LC compared to the non-COPD patients (31% vs. 29%, p<0.005). LC patients with COPD were more likely to be stage I-II compared to the non-COPD LC population (39% vs. 24%, p<0.05).

Conclusions

This study reveals a substantial overlap between patients with COPD and patients undergoing LC diagnostics (20%). It suggests that patients more affected by COPD are more likely to undergo LC diagnostics, and LC patients with COPD are more likely to be diagnosed in early stages. It underlines the overrepresentation of LC patients among patients with COPD, and emphasizes the need to address these patients specifically once initiating a screening program.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Margrethe Bang Henriksen.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.