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Schwartz AG, Lusk CM, Wenzlaff AS, Watza D, Pandolfi S, Mantha L, Cote ML, Soubani AO, Walworth G, Wozniak A, Neslund-Dudas C, Ardisana AA, Flynn MJ, Song T, Spizarny DL, Kvale PA, Chapman RA, Gadgeel SM. Risk of Lung Cancer Associated with COPD Phenotype Based on Quantitative Image Analysis. Cancer Epidemiol Biomarkers Prev 2016; 25:1341-7. [PMID: 27383774 DOI: 10.1158/1055-9965.epi-16-0176] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 05/31/2016] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a risk factor for lung cancer. This study evaluates alternative measures of COPD based on spirometry and quantitative image analysis to better define a phenotype that predicts lung cancer risk. METHODS A total of 341 lung cancer cases and 752 volunteer controls, ages 21 to 89 years, participated in a structured interview, standardized CT scan, and spirometry. Logistic regression, adjusted for age, race, gender, pack-years, and inspiratory and expiratory total lung volume, was used to estimate the odds of lung cancer associated with FEV1/FVC, percent voxels less than -950 Hounsfield units on the inspiratory scan (HUI) and percent voxels less than -856 HU on expiratory scan (HUE). RESULTS The odds of lung cancer were increased 1.4- to 3.1-fold among those with COPD compared with those without, regardless of assessment method; however, in multivariable modeling, only percent voxels <-856 HUE as a continuous measure of air trapping [OR = 1.04; 95% confidence interval (CI), 1.03-1.06] and FEV1/FVC < 0.70 (OR = 1.71; 95% CI, 1.21-2.41) were independent predictors of lung cancer risk. Nearly 10% of lung cancer cases were negative on all objective measures of COPD. CONCLUSION Measures of air trapping using quantitative imaging, in addition to FEV1/FVC, can identify individuals at high risk of lung cancer and should be considered as supplementary measures at the time of screening for lung cancer. IMPACT Quantitative measures of air trapping based on imaging provide additional information for the identification of high-risk groups who might benefit the most from lung cancer screening. Cancer Epidemiol Biomarkers Prev; 25(9); 1341-7. ©2016 AACR.
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Affiliation(s)
- Ann G Schwartz
- Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.
| | - Christine M Lusk
- Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
| | - Angela S Wenzlaff
- Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
| | - Donovan Watza
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
| | - Stephanie Pandolfi
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
| | | | - Michele L Cote
- Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
| | - Ayman O Soubani
- Karmanos Cancer Institute, Detroit, Michigan. Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan
| | - Garrett Walworth
- Department of Radiology, Karmanos Cancer Institute, Detroit, Michigan
| | - Antoinette Wozniak
- Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
| | - Christine Neslund-Dudas
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan. Josephine Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan
| | - Amy A Ardisana
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan. Josephine Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan
| | - Michael J Flynn
- Josephine Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan. Department of Radiology, Henry Ford Health System, Detroit, Michigan
| | - Thomas Song
- Josephine Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan. Department of Radiology, Henry Ford Health System, Detroit, Michigan
| | - David L Spizarny
- Josephine Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan. Department of Radiology, Henry Ford Health System, Detroit, Michigan
| | - Paul A Kvale
- Josephine Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan. Department of Pulmonary and Critical Care Medicine, Henry Ford Health System, Detroit, Michigan
| | - Robert A Chapman
- Josephine Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan. Department of Hematology/Oncology, Henry Ford Health System, Detroit, Michigan
| | - Shirish M Gadgeel
- Karmanos Cancer Institute, Detroit, Michigan. Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
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