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Airways Obstruction and the Risk for Lung Cancer

MELVYN S. TOCKMAN, M.D., Ph.D.; NICHOLAS R. ANTHONISEN, M.D.; ELIZABETH C. WRIGHT, Ph.D.; and MICHELE G. DONITHAN, M.S.
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Grant support: The IPPB trial was supported by grants NO1-HR-72901, 72902, 72903, 72904, 72905, and 72906 from the Division of Lung Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, U. S. Department of Health and Human Services. The John Hopkins Lung Project was supported by the Lung Cancer Control, Detection and Therapy, Phase II, NCI-PHS contract no. N01-CN-45037; the Clinical Inpatient Research Center Grant (Osler-5), NIH-PHS grant M011-RR-00035-21; and the Outpatient General Clinical Research Center Grant, NCI-PHS grant RR-0072 from the National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services.

▸Requests for reprints should be addressed to Melvyn S. Tockman, M.D.; Johns Hopkins Center for Occupational and Environmental Health, 3100 Wyman Park Drive, Building 6; Baltimore, MD 21211.


© 1987 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1987;106(4):512-518. doi:10.7326/0003-4819-106-4-512
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The presence of airways obstruction identify middle-aged male smokers at increased risk for lung cancer. This hypothesis was tested in a sample of patients with moderate to severe obstruction from the Intermittent Positive Pressure Breathing Trial and a sample of patients with no obstruction to moderate obstruction from the Johns Hopkins Lung Project, all of whom were followed for the development of lung cancer. On follow-up, the risk of developing lung cancer was found to be associated with entry values for age, smoking, and ventilatory status by linear, proportional hazard, and log-linear adjustment techniques. Among cigarette smokers, the presence of airways obstruction was more of an indicator for the subsequent development of lung cancer than was age or the level of smoking. The risk for lung cancer also increased in proportion to the degree of airways obstruction. These data suggest that smokers with ventilatory obstruction are at greater risk for lung cancer than are smokers without obstruction.

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