Chronic obstructive pulmonary disease among lung cancer-free smokers: The importance of healthy controls
| Autor: | Carol J. Etzel, Randa El-Zein, Michelle D. Karpman, Sanjay Shete, Jack L. Follis, Ronald C. Eldridge |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Risk 0301 basic medicine Pulmonary and Respiratory Medicine Spirometry medicine.medical_specialty Lung Neoplasms Population Disease Asymptomatic Article Tobacco smoke Pulmonary Disease Chronic Obstructive 03 medical and health sciences 0302 clinical medicine Internal medicine Confidence Intervals Prevalence medicine Humans education Lung cancer education.field_of_study COPD Smokers medicine.diagnostic_test business.industry Smoking Middle Aged medicine.disease Healthy Volunteers respiratory tract diseases 030104 developmental biology Case-Control Studies 030220 oncology & carcinogenesis Relative risk Female Disease Susceptibility medicine.symptom business |
| Zdroj: | Respiratory Investigation. 56:28-33 |
| ISSN: | 2212-5345 |
| Popis: | Background The prevalence of chronic obstructive pulmonary disease (COPD) in smokers enrolled as "healthy" controls in studies is 10–50%. The COPD status of ideal smoker populations for lung cancer case-control studies should be checked via spirometry; however, this is often not feasible, because no medical indications exist for asymptomatic smokers to undergo spirometry prior to study enrollment. Therefore, there is an unmet need for robust, cost effective assays for identifying undiagnosed lung disease among asymptomatic smokers. Such assays would help excluding unhealthy smokers from lung cancer case-control studies. Methods We used the cytokinesis-blocked micronucleus (CBMN) assay (a measure of genetic instability) to identify undiagnosed lung disease among asymptomatic smokers. We used a convenience population from an on-going lung cancer case-control study including smokers with lung cancer ( n = 454), smoker controls ( n = 797), and a self-reported COPD ( n = 200) contingent within the smoker controls. Results Significant differences for all CBMN endpoints were observed when comparing lung cancer to All controls (which included COPD) and Healthy controls (with no COPD). The risk ratio (RR) was increased in the COPD group vs. Healthy controls for nuclear buds (RR 1.28, 95% confidence interval 1.01–1.62), and marginally increased for micronuclei (RR 1.06, 0.98–1.89) and nucleoplasmic bridges (RR 1.07, 0.97–1.15). Conclusion These findings highlight the importance of using truly healthy controls in studies geared toward assessment of lung cancer risk. Using genetic instability biomarkers would facilitate the identification of smokers susceptible to tobacco smoke carcinogens and therefore predisposed to either disease. |
| Databáze: | OpenAIRE |
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