Chronic obstructive pulmonary disease, as the name indicates, is a chronic, incurable condition. It takes a toll on the body, in particular the lungs, and that can increase your chances of developing other diseases and chronic conditions.
One such related disease is lung cancer. Both lung cancer and COPD occur in the lungs. Both diseases are related to tobacco use. And, as it turns out, having COPD puts you at higher risk of developing lung cancer in the future.
[See: 7 Things You Didn’t Know About Lung Cancer.]
According to a large, global study conducted at the Harvard T.H. Chan School of Public Health in Boston, “COPD patients have a 1.86-fold higher risk” of small cell lung cancer. The study was the largest-ever epidemiologic analysis of small cell lung cancer that looked at how COPD can increase a smokers’ risk of developing SCLC, a form of lung cancer that accounts for about 15 percent of lung cancer cases worldwide. But the connection between COPD and lung cancer is also present with non-small cell lung cancers, which constitute the majority of lung cancer cases. And this connection between COPD and lung cancer appears to be a two-way street: COPD patients are more likely to develop lung cancer than people who don’t have COPD, and lung cancer patients are more likely to also have COPD than people without lung cancer.
A big risk factor that heightens your chances of developing one or the other or both diseases is a history of cigarette smoking. But scientific evidence indicates that smoking isn’t the only connection between the two diseases. A 2016 review study published in the International Journal of COPD found that “40 to 70 percent of lung cancer patients also have COPD and the risk of COPD is sixfold higher in lung cancer patients than in matched smokers, leading to the conclusion that COPD and lung cancer must share risk factors other than tobacco exposure.” The authors proposed that airflow limitation and genetics may be underlying causes of one or both diseases.
A 2010 study in the American Journal of Respiratory and Critical Care Medicine suggests that “chronic inflammation associated with COPD likely plays a role in the pathogenesis of lung cancer, just as chronic inflammation contributes to malignant transformation in other organs,” meaning that the damage to lung cells that results in COPD may also result in the next generation of lung cells mutating and becoming cancerous. Inflammation causes a higher cell turnover rate, which can lead to DNA errors, “resulting in amplification of the carcinogenic effects of cigarette smoke,” the authors write. That means the more damaged your lungs are, the more likely that exposure to cigarette smoke or other inhaled irritants will lead to either COPD or lung cancer or a worsening of one or both diseases if they already exist.
[See: 7 Lifestyle Tips to Manage Your Asthma.]
Because both COPD and lung cancer can develop in people who don’t smoke or who don’t have a history of inhaling pollutants or other substances that could damage the lungs, there’s also likely a genetic aspect to both diseases. With COPD, one such genetic factor is alpha-1 antitrypsin deficiency, a rare genetic disorder in which proteins manufactured in the liver can’t move to perform their protective and restorative role in the lungs. Studies support the theory that alpha-1 antitrypsin deficiency could also be implicated in the development of some lung cancers. A 2008 study published in the journal Thorax suggests that “alpha-1 antitrypsin deficiency carriers are at a 70 to 100 percent increased risk of lung cancer, particularly adenocarcinoma and squamous cell subtypes (adjusted for the effects of tobacco smoke exposure and COPD).” This finding is in line with another study, also published in 2008, in the journal Archives of Internal Medicine, which pegged that risk rate of developing lung cancer at 70 percent in people with alpha-1 antitrypsin deficiency. Fortunately, alpha-1 antitrypsin deficiency is a rare condition affecting an estimated 100,000 people in the U.S. It’s implicated in about 3 percent of COPD cases, the Alpha-1 Foundation reports.
There may well be other genetic links, too, as some nonsmokers who aren’t alpha-1 antitrypsin deficient may still develop COPD and/or lung cancer. Still, smokers are the largest at-risk group for both COPD and lung cancer, so quitting smoking now if you still do is the first step toward reducing your risk of one or both of these diseases.
Because chronic inflammation has been linked with COPD and lung cancer, some doctors look to treat this inflammation with inhaled corticosteroids. These medications can be effective in reducing the severity of inflammation in the lungs, and subsequently may help patients manage their COPD. In addition, a 2007 University of Washington study found that the use of inhaled corticosteroids to treat COPD was associated with a reduction in the risk of developing lung cancer.
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If you have COPD, talk to your doctor about your risk of developing lung cancer. Not all COPD patients develop it, but since COPD patients are at greater risk of the disease, it’s important to stay vigilant. The U.S. Preventive Services Task Force currently recommends that adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years should have annual low-dose computed tomography screening for lung cancer. (A pack year is the number of packs of cigarettes per day you smoked multiplied by the years you smoked. So if you smoked two packs per day for 15 years, you’d have a 30 pack-year smoking history.) But even if you weren’t a smoker, if you have COPD, talk to your doctor about whether and how frequently you should be screened for lung cancer. Catching lung cancer early improves your chances of survival.
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Are COPD Patients More Likely to Develop Lung Cancer? originally appeared on usnews.com
