Lung Cancer among outpatients with Chronic Obstructive Pulmonary Disease - A seven-year cohort Study

Lung cancer (LC) is the most common cause of cancer-related deaths worldwide, and its prognosis upon metastasis remains poor. Patients with chronic obstructive pulmonary disease (COPD) face a significantly elevated LC risk, up to six times greater than those with normal lung function. We aim to investigate LC prevalence and stage distribution among COPD outpatients. Furthermore, to outline the COPD-related variables associated with referral for LC examination.We conducted a retrospective analyses encompassing the period from January 1, 2012, to December 31, 2018, on all outpatients with COPD, LC, and individuals referred to LC examinations.Among all COPD outpatients, 2231 patients (18%) were referred for LC examinations, and 565 were diagnosed with LC (4.6%). LC patients with COPD were more likely to be stage I-II in contrast to the non-COPD LC population (46%versus26%, p<0.001 for all). Patients referred to LC examinations exhibited higher consumption of COPD-related medications, reported more severe dyspnea (69%versus66% with MRC >2), and experienced a greater frequency of exacerbations (30%versus24% with ≥2 exacerbations).Our study reveals a notable high LC incidence among COPD outpatients. LC patients with COPD were diagnosed at earlier stages, and outpatients with more pronounced COPD symptoms were more inclined to undergo LC diagnostics. The overrepresentation of LC cases among COPD outpatients emphasizes the importance of tailoring specific screening initiatives for this demographic.