History of Chronic Obstructive Pulmonary Disease May Contribute to Earlier Diagnosis of Lung Cancer

Lung cancer (LC) and chronic obstructive pulmonary disease (COPD) are significant diseases due to both their serious health consequences and their prevalence in the population. However, there is a lack of contemporary data on the relationship between these diseases in the context of modern LC treatments, particularly immunotherapy. The aim of this study was, therefore, to compare the characteristics and prognosis of patients with LC with or without COPD.

This retrospective multicentre study included all patients from the Czech LUCAS registry who had recorded baseline tumour characteristics and information on the presence or absence of COPD prior to LC diagnosis. Overall survival (OS) was assessed using Kaplan-Meier estimates, with differences between groups evaluated by the log-rank test and multivariate Cox regression model, adjusting for covariates and stratifying by disease stage when proportional hazards assumptions were violated.

A total of 815 patients were included, of whom 264 (32%) had COPD as a comorbidity. These patients were significantly more often diagnosed at potentially operable stages (I-IIIA) compared to patients without COPD (31% vs. 17%, p<0.001). Nevertheless, patients with and without COPD had similar prognosis (median OS 15.0 months vs. 14.6 months, p=0.5). This finding was confirmed by the multivariate Cox regression model.

Although patients with LC and COPD are diagnosed at a lower clinical stage of LC (likely due to regular monitoring by pneumologists), this does not translate into improved prognosis, which is comparable to that of patients without COPD.