Abstract: Chronic obstructive pulmonary disease (COPD) and lung cancer share a common etiological factor (cigarette smoking) and usually coexist in everyday clinical practice. The prevalence of COPD among newly diagnosed patients with lung cancer sometimes exceeds 50%. COPD is an independent risk factor (2–4 times higher than non-COPD subjects) for lung cancer development.

The presence of emphysema in addition to other factors (e.g., smoking history, age) could be incorporated into risk scores in order to define the most appropriate target group for lung cancer screening using low-dose computed tomography. Clinical management of patients with coexistence of COPD and lung cancer requires a multidisciplinary oncology board that includes a pulmonologist. Detailed evaluation (lung function tests, cardiopulmonary exercise test) and management (inhaled drugs, smoking cessation, pulmonary rehabilitation) of COPD should be taken into account for lung cancer treatment (surgical approach, radiotherapy).

Keywords: lung cancer, COPD, coexistence, risk factor, therapy decisions

Introduction

Chronic obstructive pulmonary disease (COPD) and lung cancer are among the most common causes of death worldwide,1 and as they have the same etiological factor (cigarette smoking) they usually coexist in everyday clinical practice.2

Lung cancer is the leading cause of cancer in the USA, even though it is the second in prevalence for both sexes. Recently published worldwide statistics showed that it is also the leading cause of cancer death among men and the second cause of cancer death among women.3 The 5-year survival rates are quite disappointing (17.9% for the USA), even though there is a statistically significant improvement during the last years (−2.3% in mortality between 2004 and 2013).4

On the other hand, COPD is a common disease – especially among current/former smokers and the elderly – as it was estimated that 10% of adults >40 years old suffered from clinically important disease (spirometric stage II or higher).5 According to World Health Organization, COPD is the third leading cause of death worldwide accounting for 3.2 million of deaths in 2015.6 The aim the present review article is to point out the treatment challenges of patients who suffer from lung cancer and COPD simultaneously.

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