Revista Clínica Española (English Edition) Revista Clínica Española (English Edition)
Rev Clin Esp 2017;217:387-93 - Vol. 217 Num.7 DOI: 10.1016/j.rceng.2017.06.001
Original article
Incidence of cancer in outpatients with chronic obstructive pulmonary disease
Incidencia de cáncer en pacientes ambulatorios con enfermedad pulmonar obstructiva crónica
J.M. Figueira Gonçalvesa,, , R. Dorta Sáncheza, L.I. Pérez Méndezb,c, L. Pérez Negrína, I. García-Talaveraa, A. Pérez Rodrígueza, D. Díaz Péreza, P. Viña Manriquea, C. Guzmán Sáenza
a Pneumology and Thoracic Surgery Service, University Hospital Nuestra Sen??ora de Candelaria, Santa Cruz de Tenerife, Spain
b Department of Clinical Epidemiology and Biostatistics, Research Unit, University Hospital Nuestra Sen??ora de Candelaria and Primary Care Management, Santa Cruz de Tenerife, Spain
c CIBER de Enfermedades Respiratorias, Instituto de Salud CArlos III, Madrid, Spain
Received 02 February 2017, Accepted 14 June 2017

The relationship between chronic obstructive pulmonary disease (COPD) and the overall incidence of cancer is poorly understood. The aim of this study was to analyze the incidence of cancer (pulmonary and extrapulmonary sites) in patients with COPD followed up in a specialized outpatient unit, and to assess the relationship to the degree of airflow obstruction.


A prospective observational study was conducted with a cohort of 308 patients with COPD followed up at pulmonology outpatient clinics from January 2012 to December 2015. The neoplasms diagnosed during this period were divided into a pulmonary and an extrapulmonary group.


The overall yearly incidence rates of cancer, lung cancer and extrapulmonary cancer cases per 1000 patients with COPD were 10.3, 3.4 and 7.3 cases, respectively. The most frequent cancer types were lung cancer (31%), genitourinary tract cancer (29%) and gastrointestinal cancer (21%). Mild to moderate stages (grade I–II of the 2009 GOLD classification) and the increase in the pack-year index (PYI) were related to an increase in the onset of neoplasia, with an odds ratio (OR) of 2.16 (95% confidence interval [95% CI]: 1.087–4.309; p=.026) and 1.01 (95% CI: 1.002–1.031; p=.023), respectively.


The incidence of extrapulmonary cancer in patients with COPD was twice that of lung cancer; stages I–II of the 2009 GOLD classification and the PYI were significantly related to the onset of neoplasia.


La relación entre la enfermedad pulmonar obstructiva crónica (EPOC) y la incidencia global de cáncer es poco conocida. El objetivo del estudio fue analizar la incidencia de cáncer (tanto de localización pulmonar como extrapulmonar) en pacientes con EPOC en seguimiento en una consulta ambulatoria especializada, así como valorar su relación con el grado de obstrucción al flujo aéreo.


Estudio observacional prospectivo de una cohorte de 308 pacientes con EPOC en seguimiento en consultas ambulatorias de neumología durante el periodo comprendido entre enero de 2012 y diciembre de 2015. Las neoplasias diagnosticadas en este periodo se dividieron en pulmonares y extrapulmonares.


Las tasas de incidencia global de cáncer, de cáncer de pulmón (CP) y de cáncer extrapulmonar fueron de 10,3, 3,4 y 7,3 casos por 1.000 pacientes EPOC-año, respectivamente. Los tumores más frecuentes fueron el CP (31%), los del tracto genitourinario (29%) y digestivo (21%). Los estadios leve-moderado (gradosI-II de la GOLD 2009) y el incremento del índice paquetes-año (IPA) se relacionaron con un aumento en la aparición de neoplasias con un odds ratio (OR) de 2,16 (intervalo de confianza al 95% [IC95%]: 1,087-4,309; p=0,026) y 1,01 (IC95%:1,002-1,031; p=0,023), respectivamente.


La incidencia de cáncer de localización extrapulmonar en pacientes con EPOC duplica a la de CP. Los estadiosI-II de la GOLD 2009 y el IPA se relacionan de forma significativa con la aparición de neoplasias.

Chronic obstructive pulmonary disease (COPD), Incidence, Cancer
Palabras clave
Enfermedad pulmonar obstructiva crónica (EPOC), Incidencia, Cáncer


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Rev Clin Esp 2017;217:387-93 - Vol. 217 Num.7 DOI: 10.1016/j.rceng.2017.06.001
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