| Title: | Respiratory Function as a Prognostic Factor for Lung Cancer in Screening and General Populations. |
| Journal: | Annals of the American Thoracic Society |
| Published: | 1 Apr 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/39589279/ |
| DOI: | https://doi.org/10.1513/annalsats.202404-428oc |
Publication 14351
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Abstract
Rationale: Despite advancements in screening, lung cancer remains the leading cause of cancer-related mortality globally. Objectives: To investigate respiratory function as a prognostic factor for survival in the UK Biobank, a population-based cohort of more than 500,000 participants, and the NLST (National Lung Screening Trial), a high-risk screening population of more than 50,000 screenees. Methods: Participants with an incident lung cancer diagnosis and spirometry-assessed lung function were included. Lung cancer was measured as the ratio of forced expiratory volume in 1 second (FEV1) and forced vital capacity and percentage of predicted FEV1. Multivariable Cox proportional hazards models were fitted to estimate the impact of lung function on 5-year overall survival in populations with different baseline lung cancer risks. Results: A total of 2,690 and 609 patients were included in the analysis from the UK Biobank and the NLST, respectively. In the UK Biobank, a higher percentage of predicted FEV1 and ratio were associated with better survival after lung cancer diagnosis, with hazard ratios of 0.97 (95% confidence interval [CI], 0.95-1.00 per 10% increase) and 0.95 (95% CI, 0.90-1.00 per 10% increase), respectively. No statistically significant results were found when assessing the data from the NLST study. Conclusions: Impaired lung function was associated with poorer survival for patients with lung cancer in the general population, although this was less clear in a high-risk, screening-eligible population. This highlights the potential clinical importance of respiratory function as a prognostic factor in lung cancer in the general population and presents a possibility for personalized cancer management.</p>
14 Keywords
- Aged
- Early Detection of Cancer
- Female
- Forced Expiratory Volume
- Humans
- Lung
- Lung Neoplasms
- Male
- Middle Aged
- Prognosis
- Proportional Hazards Models
- Spirometry
- United Kingdom
- Vital Capacity
6 Authors
- Kiera R Murison
- Matthew T Warkentin
- Elham Khodayari Moez
- Yonathan Brhane
- Geoffrey Liu
- Rayjean J Hung
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