Abstract
Despite advancements in screening, lung cancer remains the leading cause of cancer-related mortality globally. To investigate respiratory function as a prognostic factor for survival in the UK Biobank, a population-based cohort of over 500,000 participants, and the National Lung Screening Trial (NLST), a high-risk screening population of over 50,000 screenees. 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. 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% 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. Impaired lung function was associated with poorer survival for lung cancer patients 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.
Published Version
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