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array:24 [ "pii" => "S2254887417300942" "issn" => "22548874" "doi" => "10.1016/j.rceng.2017.06.001" "estado" => "S300" "fechaPublicacion" => "2017-10-01" "aid" => "1412" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "copyrightAnyo" => "2017" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2017;217:387-93" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5 "formatos" => array:2 [ "HTML" => 3 "PDF" => 2 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0014256517301546" "issn" => "00142565" "doi" => "10.1016/j.rce.2017.06.004" "estado" => "S300" "fechaPublicacion" => "2017-10-01" "aid" => "1412" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2017;217:387-93" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 45 "formatos" => array:2 [ "HTML" => 31 "PDF" => 14 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Incidencia de cáncer en pacientes ambulatorios con enfermedad pulmonar obstructiva crónica" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "387" "paginaFinal" => "393" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Incidence of cancer in outpatients with chronic obstructive pulmonary disease" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1254 "Ancho" => 1663 "Tamanyo" => 76512 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Probabilidad acumulada libre de cáncer en pacientes con enfermedad pulmonar obstructiva crónica.</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">*</span>Edad del paciente con enfermedad pulmonar obstructiva crónica en el momento de diagnóstico de cáncer. Línea discontinua: GOLD<span class="elsevierStyleHsp" style=""></span>III-IV. Línea continua: GOLD<span class="elsevierStyleHsp" style=""></span>I-II<span class="elsevierStyleSmallCaps">.</span> Log rank test, p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,072.</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">EPOC: enfermedad pulmonar obstructiva crónica; GOLD: <span class="elsevierStyleItalic">Global Initiative for Chronic Obstructive Lung Disease</span>.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.M. Figueira Gonçalves, R. Dorta Sánchez, L.I. Pérez Méndez, L. Pérez Negrín, I. García-Talavera, A. Pérez Rodríguez, D. Díaz Pérez, P. Viña Manrique, C. Guzmán Sáenz" "autores" => array:9 [ 0 => array:2 [ "nombre" => "J.M." "apellidos" => "Figueira Gonçalves" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Dorta Sánchez" ] 2 => array:2 [ "nombre" => "L.I." "apellidos" => "Pérez Méndez" ] 3 => array:2 [ "nombre" => "L." "apellidos" => "Pérez Negrín" ] 4 => array:2 [ "nombre" => "I." "apellidos" => "García-Talavera" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Pérez Rodríguez" ] 6 => array:2 [ "nombre" => "D." "apellidos" => "Díaz Pérez" ] 7 => array:2 [ "nombre" => "P." "apellidos" => "Viña Manrique" ] 8 => array:2 [ "nombre" => "C." "apellidos" => "Guzmán Sáenz" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2254887417300942" "doi" => "10.1016/j.rceng.2017.06.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887417300942?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256517301546?idApp=WRCEE" "url" => "/00142565/0000021700000007/v1_201709280106/S0014256517301546/v1_201709280106/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2254887417300413" "issn" => "22548874" "doi" => "10.1016/j.rceng.2017.04.002" "estado" => "S300" "fechaPublicacion" => "2017-10-01" "aid" => "1381" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2017;217:398-404" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 7 "formatos" => array:2 [ "HTML" => 3 "PDF" => 4 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Special Article</span>" "titulo" => "Hyponatraemia and congestive heart failure refractory to diuretic treatment. Utility of tolvaptan" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "398" "paginaFinal" => "404" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hiponatremia e insuficiencia cardiaca congestiva refractaria a tratamiento diurético. Utilidad del tolvaptán" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2593 "Ancho" => 3340 "Tamanyo" => 475770 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Action algorithm for congestive patients with hyponatremia. <span class="elsevierStyleItalic">Abbreviations</span>: HF, heart failure; IV, intravenous; NaP, plasma sodium concentration; HSS: hypertonic saline serum.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Pose, L. Almenar, L. Manzano, J.J. Gavira, A. López Granados, J. Delgado, O. Aramburu, J.C. Arévalo, M. Méndez, J. Comín, N. Manito" "autores" => array:11 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Pose" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Almenar" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Manzano" ] 3 => array:2 [ "nombre" => "J.J." "apellidos" => "Gavira" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "López Granados" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Delgado" ] 6 => array:2 [ "nombre" => "O." "apellidos" => "Aramburu" ] 7 => array:2 [ "nombre" => "J.C." "apellidos" => "Arévalo" ] 8 => array:2 [ "nombre" => "M." "apellidos" => "Méndez" ] 9 => array:2 [ "nombre" => "J." "apellidos" => "Comín" ] 10 => array:2 [ "nombre" => "N." "apellidos" => "Manito" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0014256517300760" "doi" => "10.1016/j.rce.2017.02.013" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256517300760?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887417300413?idApp=WRCEE" "url" => "/22548874/0000021700000007/v1_201709280051/S2254887417300413/v1_201709280051/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2254887417300796" "issn" => "22548874" "doi" => "10.1016/j.rceng.2017.05.003" "estado" => "S300" "fechaPublicacion" => "2017-10-01" "aid" => "1403" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2017;217:381-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 11 "formatos" => array:2 [ "HTML" => 5 "PDF" => 6 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Epidemiological and sociodemographic factors associated with complicated alcohol withdrawal syndrome" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "381" "paginaFinal" => "386" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Factores epidemiológicos y sociodemográficos asociados al síndrome de abstinencia alcohólica complicado" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. Monte-Secades, M. Blanco-Soto, J.A. Díaz-Peromingo, A. Sanvisens-Bergé, M.C. Martín-González, A. Barbosa, B. Rosón-Hernández, M.A. Tejero-Delgado, R. Puerta-Louro, R. Rabuñal-Rey" "autores" => array:11 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "Monte-Secades" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Blanco-Soto" ] 2 => array:2 [ "nombre" => "J.A." "apellidos" => "Díaz-Peromingo" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Sanvisens-Bergé" ] 4 => array:2 [ "nombre" => "M.C." "apellidos" => "Martín-González" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Barbosa" ] 6 => array:2 [ "nombre" => "B." "apellidos" => "Rosón-Hernández" ] 7 => array:2 [ "nombre" => "M.A." "apellidos" => "Tejero-Delgado" ] 8 => array:2 [ "nombre" => "R." "apellidos" => "Puerta-Louro" ] 9 => array:2 [ "nombre" => "R." "apellidos" => "Rabuñal-Rey" ] 10 => array:1 [ "colaborador" => "Grupo de Trabajo Alcohol y Alcoholismo, Sociedad Española de Medicina Interna" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0014256517301315" "doi" => "10.1016/j.rce.2017.05.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256517301315?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887417300796?idApp=WRCEE" "url" => "/22548874/0000021700000007/v1_201709280051/S2254887417300796/v1_201709280051/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Incidence of cancer in outpatients with chronic obstructive pulmonary disease" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "387" "paginaFinal" => "393" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J.M. Figueira Gonçalves, R. Dorta Sánchez, L.I. Pérez Méndez, L. Pérez Negrín, I. García-Talavera, A. Pérez Rodríguez, D. Díaz Pérez, P. Viña Manrique, C. Guzmán Sáenz" "autores" => array:9 [ 0 => array:4 [ "nombre" => "J.M." "apellidos" => "Figueira Gonçalves" "email" => array:1 [ 0 => "juanmarcofigueira@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "R." "apellidos" => "Dorta Sánchez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "L.I." "apellidos" => "Pérez Méndez" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "L." "apellidos" => "Pérez Negrín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "I." "apellidos" => "García-Talavera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "A." "apellidos" => "Pérez Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 6 => array:3 [ "nombre" => "D." "apellidos" => "Díaz Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 7 => array:3 [ "nombre" => "P." "apellidos" => "Viña Manrique" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 8 => array:3 [ "nombre" => "C." "apellidos" => "Guzmán Sáenz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Pneumology and Thoracic Surgery Service, University Hospital Nuestra Sen¿ora de Candelaria, Santa Cruz de Tenerife, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Clinical Epidemiology and Biostatistics, Research Unit, University Hospital Nuestra Sen¿ora de Candelaria and Primary Care Management, Santa Cruz de Tenerife, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "CIBER de Enfermedades Respiratorias, Instituto de Salud CArlos III, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Incidencia de cáncer en pacientes ambulatorios con enfermedad pulmonar obstructiva crónica" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1254 "Ancho" => 1663 "Tamanyo" => 76215 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Cumulative probability of being cancer free for patients with chronic obstructive pulmonary disease.</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">*Age of the patient with chronic obstructive pulmonary disease at the time of cancer diagnosis. Dashed line: GOLD III–IV. Continuous line: GOLD I–II<span class="elsevierStyleSmallCaps">.</span> Log rank test, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.072.</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>: COPD, chronic obstructive pulmonary disease; GOLD, Global Initiative for Chronic Obstructive Lung Disease.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Background</span><p id="par0005" class="elsevierStylePara elsevierViewall">Tobacco use has been defined as the main preventable cause of premature mortality and constitutes one of the main health problems in developed countries.<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">1–4</span></a> The ingredients of tobacco include ammonia, pyridine, tar, polycyclic aromatic hydrocarbons and nitrosamines, whose combustion releases more than 4000 hazardous substances, at least 60 out of which have been demonstrated to be carcinogenic.<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In addition to being responsible for 90% of lung cancers, tobacco smoke has been shown to have a solid relationship with the development of cancer at other sites, including the oral cavity, larynx, esophagus, bladder, kidneys, pancreas, stomach, colon, rectum and cervix.<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">6–11</span></a> Apart from its carcinogenic effects, tobacco smoke has a role as a risk factor for the development of the main chronic cardiovascular and respiratory diseases, the latter of which include disorders such as bronchial asthma, respiratory infections and chronic obstructive pulmonary disease (COPD).<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">12,13</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Lung cancer and COPD seem to share common environmental exposure factors beyond smoking.<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">14–17</span></a> COPD is known to increase three to fivefold fold the risk of developing lung cancer.<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">15,18–22</span></a> Chronic bronchitis, emphysema and the degree of bronchial obstruction are independent risk factors for the onset of lung cancer.<a class="elsevierStyleCrossRefs" href="#bib0335"><span class="elsevierStyleSup">18–29</span></a> Moreover, various studies have demonstrated an increase in the development of extrapulmonary tumors in patients with COPD compared with smokers without obstruction.<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">30–35</span></a> Although direct toxicity of tobacco-derived metabolic products may be responsible for this increase, the underlying inflammatory process in a chronic disease such as COPD could play a crucial role in the carcinogenic response of various organs, amplifying mutagenesis and facilitating tumor growth and subsequent metastatic spread.<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">7,36–39</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The incidence rate of lung cancer in patients with COPD ranges from 1.4 to 16.7 per 1000 person-years.<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">19,22,40</span></a> However, the exact overall incidence rate for cancer, especially extrapulmonary cancer, is not known. The aim of this study was to determine incidence rate of both pulmonary and extrapulmonary cancer in a followed-up, pulmonology outpatient population with COPD and to assess its relationship to the degree of airflow obstruction.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">An observational, prospective study was conducted with a cohort of patients with COPD followed up at outpatient pulmonology clinics of the University Hospital Nuestra Señora de Candelaria (HUNSC) between January 1, 2012 and December 31, 2015. The included population represented the southern and capital area of the island of Tenerife, which has a reference population of 452,000 inhabitants and 22 health areas.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Inclusion criteria comprised an age over 40 years, active smokers or ex-smokers with a pack-year index (PYI) ≥10 and a post-bronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) < 70%. Exclusion criteria were the presence of chronic respiratory disease other than COPD, a previous cancer diagnosis and the presence of chronic airflow obstruction without exposure to tobacco smoke or a PYI <10.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Through the computerized medical history, we collected the following parameters from each patient: age, sex, body mass index (BMI, i.e. weight in kg/height in m<span class="elsevierStyleSup">2</span>), smoking (active smoker if the patient has smoked at least 1 cigarette in the past 6 months; ex-smoker if the patient had been a smoker but had ceased for at least a continuous 6-month period; non-smoker if the patient had never smoked) and the intensity of the smoking by means of the PYI calculation ([number of daily cigarettes<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>years of smoking]/20). Likewise, the forced spirometry results FEV<span class="elsevierStyleInf">1</span>, FVC and FEV<span class="elsevierStyleInf">1</span>/FVC were recorded and patients stratified according to the degree of severity recorded in the 2009 GOLD guidelines<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">41</span></a> and the 2017 GOLD categories.<a class="elsevierStyleCrossRef" href="#bib0455"><span class="elsevierStyleSup">42</span></a> According to the 2009 GOLD guidelines, COPD severity is classified into the following stages: mild (stage <span class="elsevierStyleSmallCaps">I</span>) FEV<span class="elsevierStyleInf">1</span> ≥80%; moderate (stage <span class="elsevierStyleSmallCaps">II</span>) FEV<span class="elsevierStyleInf">1</span> ≥50% and <80%; severe (stage <span class="elsevierStyleSmallCaps">III</span>) FEV<span class="elsevierStyleInf">1</span> ≥30% and <50%; and very severe (stage <span class="elsevierStyleSmallCaps">IV</span>) FEV<span class="elsevierStyleInf">1</span> <30%. The 2017 GOLD guidelines added a letter (A, B, C, or D) to stages <span class="elsevierStyleSmallCaps">I–IV</span>, which provides information on the patient's symptoms and risk of exacerbation. Group A and B patients suffer <2 exacerbations/year without hospitalization, while the groups C and D represent patients with 2 or more exacerbations/year, at least 1 hospitalization or both. Additionally, groups A and C correspond to patients with a dyspnea score of 0–1 (evaluated with the modified dyspnea scale of the Medical Research Council [mMRC]) and/or scored <10 in the COPD Assessment Test (CAT). Groups B and D include patients with an mMRC ≥2, a CAT score ≥10 or both.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Incident cases of cancer and their date of diagnosis during the study period were categorized for subsequent analysis into pulmonary and extrapulmonary cancer. Skin cancer other than melanoma was excluded. Cancer diagnosis was performed by the specialists from the hospital. Deaths in the cohort during the study period (January 2012 to December 2015) were counted.</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Statistical analysis</span><p id="par0045" class="elsevierStylePara elsevierViewall">An initial descriptive analysis was conducted using mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>standard deviation (SD) for the numerical variables and percentages (%) for the qualitative ones. For point estimates and the 95% confidence intervals (95% CI) of the cancer incidence rate, we used the follow-up period of each patient in months as the denominator, divided by the person-time index until the cancer diagnosis event or the completion of the follow-up period. We calculated overall as well as group-specific rates (pulmonary and extrapulmonary cancer). Bivariate analysis of the cancer incidence according to patients characteristics as to the computerized medical history employed Chi-squared, Student's t, or ANOVA test, based on the nature of the variable (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Multivariate analysis was performed using multiple logistic regression (conditional mode).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">For the prospective assessment of the disease-free time (in years) to cancer diagnosis or the end of follow-up in December 2015, we employed a survival analysis, expressing the “cumulative disease-free percentage” as survival. The event to measure was the diagnosis of cancer (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). We used Cox regression for multivariate adjustment and the log rank test for comparing the GOLD categories regrouped in dichotomous format (<span class="elsevierStyleSmallCaps">I<span class="elsevierStyleMonospace">-</span>II</span>vs. <span class="elsevierStyleSmallCaps">III–IV</span>), as these groups better discriminated differences between “cumulative disease-free percentages”.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">All hypothesis tests were bilateral, for a significance level of 5%. The analyses were performed using the statistical SPSS/PC program (version 21.0 for Windows; SPSS Inc., Chicago, IL). The study was approved by the Ethics Committee of the HUNSC.</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0060" class="elsevierStylePara elsevierViewall">We included 308 patients with COPD; 33 patients died, and 48 were diagnosed with cancer during the study period. The incidence rate was therefore 10.3 cases per 1000 COPD cases per year (95% CI 7.6–13.6 cases). The most frequent tumors were lung tumors (31%), genitourinary tract tumors (29%), gastrointestinal tumors (21%), head/neck tumors (6%) and miscellaneous (12.5%). In terms of location, the annual incidence rate for lung cancer was 3.4 cases per 1000 COPD cases per year (95% CI 1.9–5.6 cases). For extrapulmonary tumors, the rate was 7.3 cases per 1000 COPD cases per year (95% CI 5–10 cases). These values reflect an incidence rate of 2.14 (95% CI 1.16–3.94) in favor of malignancies of extrapulmonary origin (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.017).</p><p id="par0065" class="elsevierStylePara elsevierViewall">The clinical and demographic characteristics of the series and the contrasts of the cross-sectional bivariate analysis are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. Cancer diagnoses were more frequent in patients with a higher PYI, but we did not detect significant differences in the other variables.</p><p id="par0070" class="elsevierStylePara elsevierViewall">In the multivariate logistic regression analysis, we observed a significant increase in the mean risk of cancer in patients with mild to moderate obstruction, grouped according to the 2009 GOLD classification (grades <span class="elsevierStyleSmallCaps">I</span> and <span class="elsevierStyleSmallCaps">II</span>), compared to patients with more severe obstructions (grades III and IV), as well as in those with a higher accumulated tobacco consumption, when the rest of the variables were excluded from the equation. The adjusted odds ratio (OR) is shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>A. The prospective assessment of cancer incidence (longitudinal analysis, Cox regression) reinforced these associations by also showing a significant difference in the cumulative cancer-free probability: the patient group with mild to moderate obstruction and the one with a higher PYI had a higher cancer incidence rate (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>B).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0075" class="elsevierStylePara elsevierViewall">In this patient cohort diagnosed with COPD, the incidence rate of cancer at any site was 10.3 cases per 1000 patients with COPD per year. The incidence rate for extrapulmonary malignancies doubled that for primary pulmonary malignancies.</p><p id="par0080" class="elsevierStylePara elsevierViewall">The association between lung cancer and COPD has been clearly established.<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">15–29</span></a> The high prevalence of lung cancer in COPD suggests that there are common mechanisms in both diseases. These mechanisms include genetic, epigenetic and inflammatory factors and the structural lung impairment in COPD, which promotes the development of malignancies, beyond the adverse effect of tobacco smoke itself.<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">17,38,40</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">The incidence rate of lung cancer in patients with COPD ranges from 1.4 to 16.7 per 1000<span class="elsevierStyleHsp" style=""></span>person-years,<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">19,22,40</span></a> with our results agreeing with those published in the Lung Health Study.<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">19</span></a> Comparing our series with similar studies in the Spanish population, our incidence rate was lower than that described by Torres et al.,<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">22</span></a> which could reflect the increased tobacco consumption (mean PYI of 74.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>39.9) reported in the former study. The Cancer Prevention Study II<a class="elsevierStyleCrossRef" href="#bib0460"><span class="elsevierStyleSup">43</span></a> showed that smoking a pack of cigarettes per day for 30 years increased the specific mortality due to lung cancer by 20–40% in men and 14–20% in women, compared with individuals who had never smoked. The risk virtually doubled if the consumption was maintained for more than 40 years.<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">44</span></a> Doll and Peto<a class="elsevierStyleCrossRef" href="#bib0470"><span class="elsevierStyleSup">45</span></a> developed a quantitative model for lung cancer risk, in which the duration of smoking was more significant than the number of cigarettes smoked, in individuals with a comparable packs-per-year consumption. In this model, the association between the number of cigarettes smoked per day and the risk of lung cancer was relatively linear. However, the duration of tobacco consumption was related to an exponential increase in the risk of lung cancer. In line with these data, an association between the PYI and the development of mutations in various target organs has been found, which seems to promote not only the development of lung cancer but also extrapulmonary tumors in the bladder, colon and larynx, among others.<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">7</span></a> These results are in accordance with our findings, insofar as the overall incidence of cancer was higher in those patients with COPD who had a higher PYI.</p><p id="par0090" class="elsevierStylePara elsevierViewall">In our study, there was a notably high incidence of extrapulmonary tumors, especially in patients with COPD and mild to moderate airflow obstruction. Nakayama et al.<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">30</span></a> investigated the development of cancer in 127 patients with COPD compared to patients with no obstruction who smoked. The patients with COPD had a relative cancer risk of 2.2 (95% CI 1.24–4.27; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.0069) compared with control subjects. The most frequent tumors were lung, head and neck and urinary tract tumors. Purdue et al.<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">31</span></a> assessed the risk of cancer in construction workers diagnosed with COPD and found an increase of 2.2 (95% CI 1.8–2.7) in the risk of lung cancer and 1.6 (95% CI 1.4–2.0) in the risk of extrapulmonary cancer.</p><p id="par0100" class="elsevierStylePara elsevierViewall">Chiang et al.<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">32</span></a> demonstrated that patients with COPD have a higher risk of developing certain tumors, such as head and neck, esophageal, lung, breast, prostate, central nervous system, lymphoma and multiple myeloma tumors. In our cohort, the most frequent extrapulmonary malignancies were colorectal and prostate cancer. Although their incidence rates in the general population increase from the age of 50 years of age, which could bias the results given the mean age of our series, various studies have shown that these tumors occur more frequently in patients with COPD than in the general population.<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">32–34</span></a> Patients with COPD have a higher risk of prostate cancer (hazard ratio, 4.9; 95% CI 1.8–13.5) than patients without bronchial obstruction.<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">34</span></a> Although testosterone levels are reduced in COPD patients, a relation with the development of prostate cancer has not been established.<a class="elsevierStyleCrossRefs" href="#bib0415"><span class="elsevierStyleSup">34,46</span></a> A number of factors such as obesity, physical inactivity—circumstances commonly present in patients with COPD—and the type of diet appear to be common elements the development of colorectal and lung cancer.<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">17,47,48</span></a> Chun et al.<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">35</span></a>found that patients with COPD had a greater risk of colorectal polyps than patients without obstruction (OR, 2.1; 95% CI 1.1–3.8; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.019). The authors therefore recommended periodic colonoscopies for these patients to detect premalignant lesions.</p><p id="par0110" class="elsevierStylePara elsevierViewall">In our analysis, the incidence of extrapulmonary cancer doubled that of lung cancer, with a notable percentage of patients who developed colorectal, prostate and bladder cancer. A reasonable explanation, beyond the damage generated by the carcinogenic substances in tobacco, could be the presence of low-grade COPD-associated systemic inflammation. A number of key compounds in the pathogenic process are known to link inflammation with carcinogenesis, such as integrins, transforming growth factor beta, NF-kappa beta transcription factor, the signal transducer and activator of transcription 3, tumor necrosis factor alpha and cyclooxygenase-2.<a class="elsevierStyleCrossRefs" href="#bib0425"><span class="elsevierStyleSup">36–39</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">It is notable that patients who are more susceptible to developing cancer were those with milder stages of the disease. This fact could be due to a survival bias, where patients with more severe COPD, who could lack the predisposing factors for developing cancer, thereby reach more advanced phases of the disease.<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">49</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">This study had some limitations. Firstly, the study population came from a single hospital, and the sample size was limited. Obviously, a larger sample could have revealed differences undetected in the current analysis. Recruiting a larger, representative sample of patients with COPD throughout the Canary Islands would undoubtedly be of interest. Secondly, a potential information bias could have occurred from obtaining the variables from the patients’ medical history, although the current standardization of diagnostic criteria minimizes this possibility. Thirdly, we did not have a control group from the general population or smokers without obstruction. Therefore, we cannot rule out some factor that could explain the high number of extrapulmonary malignancies in the cohort. Lastly, we should consider the inherent limitations of a nonpopulational-based study.</p><p id="par0125" class="elsevierStylePara elsevierViewall">In conclusion, patients with COPD and a mild to moderate degree of airflow obstruction (grades I and II of the 2009 GOLD guidelines) have a greater risk of developing cancer at various sites compared with those with a more advanced obstruction.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflict of interests</span><p id="par0130" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres907009" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methodology" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec887292" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres907010" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Metodología" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec887293" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Background" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Material and methods" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0020" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0025" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflict of interests" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-02-02" "fechaAceptado" => "2017-06-14" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec887292" "palabras" => array:3 [ 0 => "Chronic obstructive pulmonary disease (COPD)" 1 => "Incidence" 2 => "Cancer" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec887293" "palabras" => array:3 [ 0 => "Enfermedad pulmonar obstructiva crónica (EPOC)" 1 => "Incidencia" 2 => "Cáncer" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">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.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methodology</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">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.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">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; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.026) and 1.01 (95% CI: 1.002–1.031; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.023), respectively.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The incidence of extrapulmonary cancer in patients with COPD was twice that of lung cancer; stages <span class="elsevierStyleSmallCaps">I–II</span> of the 2009 GOLD classification and the PYI were significantly related to the onset of neoplasia.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methodology" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducción</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">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.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Metodología</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">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.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">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 (grados<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleSmallCaps">I</span>-<span class="elsevierStyleSmallCaps">II</span> 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% [IC<span class="elsevierStyleInf">95%]</span>: 1,087-4,309; p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,026) y 1,01 (IC<span class="elsevierStyleInf">95%</span>:1,002-1,031; p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,023), respectivamente.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusión</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La incidencia de cáncer de localización extrapulmonar en pacientes con EPOC duplica a la de CP. Los estadios<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleSmallCaps">I</span>-<span class="elsevierStyleSmallCaps">II</span> de la GOLD 2009 y el IPA se relacionan de forma significativa con la aparición de neoplasias.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Metodología" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Please cite this article as: Figueira Gonçalves JM, Dorta Sánchez R, Pérez Méndez LI, Pérez Negrín L, García-Talavera I, Pérez Rodríguez A, et al. Incidencia de cáncer en pacientes ambulatorios con enfermedad pulmonar obstructiva crónica. Rev Clin Esp. 2017;217:387–393.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0020">This manuscript won the 2016 Respiratory Disease Prize of the Royal Academy of Medicine of Santa Cruz de Tenerife.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1254 "Ancho" => 1663 "Tamanyo" => 76215 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Cumulative probability of being cancer free for patients with chronic obstructive pulmonary disease.</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">*Age of the patient with chronic obstructive pulmonary disease at the time of cancer diagnosis. Dashed line: GOLD III–IV. Continuous line: GOLD I–II<span class="elsevierStyleSmallCaps">.</span> Log rank test, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.072.</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>: COPD, chronic obstructive pulmonary disease; GOLD, Global Initiative for Chronic Obstructive Lung Disease.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>: BMI, body mass index (kg/m<span class="elsevierStyleSup">2</span>); FEV<span class="elsevierStyleInf">1</span>, forced expiratory volume in one second; FVC, forced vital capacity; GOLD, Global Initiative for Chronic Obstructive Lung Disease; PYI, pack-year index; SD, standard deviation.</p>" "tablatextoimagen" => array:2 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">Overall <span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>308 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Neoplasia</th><th class="td" title="table-head " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">p</span> \t\t\t\t\t\t\n \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No<br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>260 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Yes<br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>48 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age, years (mean</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">±</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">SD)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">70<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">70<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">72<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.083 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sex</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.651 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">81.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">82 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">79 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Female (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">18.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">BMI (mean</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">±</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">SD)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">29<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">29<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">29<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.846 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">BMI</span> ≥30 <span class="elsevierStyleItalic">(%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">44.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">43.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.402 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Smoking</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.070 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ex-smoker (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">63 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">77 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Active smoker (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PYI <span class="elsevierStyleItalic">(mean</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">±</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">SD)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">46.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>21.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">45.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>20.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">52.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>24.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.047 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PYI ≥<span class="elsevierStyleItalic">60 (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.275 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Pulmonary function</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>FEV<span class="elsevierStyleInf">1</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">56.34<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>18.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">55.87<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>18.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">58.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>16.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.302 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>FVC (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">82.7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>21.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">82.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>21.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">84.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>19.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.448 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>FEV<span class="elsevierStyleInf">1</span>/FVC (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">52.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">52.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">53.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.455 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>FEV<span class="elsevierStyleInf">1</span> (L) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.48<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.59 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.48<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.61 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.46<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.831 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>FVC (L) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.80<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.89 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.81<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.91 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.71<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.494 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">GOLD 2009</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.187 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>I. Mild (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>II. Moderate (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">47.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">44.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">60.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>III. Severe (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">36.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">27.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IV. Very severe (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1525515.png" ] ] 1 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">A \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">B \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">C \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">D \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">A \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">B \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">C \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">D \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">A \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">B \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">C \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">D \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">GOLD 2017</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.652 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>I (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>II (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>III (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IV (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1525514.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Clinical and demographic characteristics of the patients with chronic obstructive pulmonary disease.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>: CI, confidence interval; GOLD, <span class="elsevierStyleItalic">Global Initiative for Chronic Obstructive Lung Disease</span>.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Odds ratio<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI Odds ratio \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">A. Transversal analysis</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GOLD 2009<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.164 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.087–4.309 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.028 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pack-year index \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.016 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.002–1.031 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.023 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">B. Longitudinal analysis</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GOLD 2009<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.100 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.112–3.963 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.022 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pack-year index \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.016 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.004–1.028 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.011 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1525513.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Mild to moderate obstruction (<span class="elsevierStyleSmallCaps">I</span>–<span class="elsevierStyleSmallCaps">II</span>) risk category.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Adjusted odds ratio.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Factors that increase the risk of cancer in patients with chronic obstructive pulmonary disease.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:49 [ 0 => array:3 [ "identificador" => "bib0250" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reducing the health consequences of smoking: 25 years of progress. A report of the Surgeon General. DHHS (CDC) 89-8411" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Department of Health and Human Services" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "1989" "editorial" => "U.S. Department of Health and Human Services" "editorialLocalizacion" => "Rockville" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0255" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.S. Lim" 1 => "T. Vos" 2 => "A.D. Flaxman" 3 => "G. Danaei" 4 => "K. Shibuya" 5 => "H. Adair-Rohani" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(12)61766-8" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2012" "volumen" => "380" "paginaInicial" => "2224" "paginaFinal" => "2260" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23245609" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0260" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cigarette smoking and lung cancer — relative risk estimates for the major histological types from a pooled analysis of case-control studies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B. Pesch" 1 => "B. Kendzia" 2 => "P. Gustavsson" 3 => "K.H. Jöckel" 4 => "G. Johnen" 5 => "H. Pohlabeln" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ijc.27339" "Revista" => array:6 [ "tituloSerie" => "Int J Cancer" "fecha" => "2012" "volumen" => "131" "paginaInicial" => "1210" "paginaFinal" => "1219" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22052329" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0265" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of cigarette smoking on cancer risk in the European prospective investigation into cancer and nutrition study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Agudo" 1 => "C. Bonet" 2 => "N. Travier" 3 => "C.A. González" 4 => "P. Vineis" 5 => "H.B. Bueno-de-Mesquita" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/JCO.2011.41.0183" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2012" "volumen" => "30" "paginaInicial" => "4550" "paginaFinal" => "4557" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23169508" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0270" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tobacco carcinogens, their biomarkers and tobacco-induced cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S.S. Hecht" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/nrc1190" "Revista" => array:6 [ "tituloSerie" => "Nat Rev Cancer" "fecha" => "2003" "volumen" => "3" "paginaInicial" => "733" "paginaFinal" => "744" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14570033" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0275" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A review of human carcinogens — Part E: Tobacco, areca nut, alcohol, coal smoke, and salted fish" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B. Secretan" 1 => "K. Straif" 2 => "R. Baan" 3 => "Y. Grosse" 4 => "F. El Ghissassi" 5 => "V. Bouvard" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lancet Oncol" "fecha" => "2009" "volumen" => "10" "paginaInicial" => "1033" "paginaFinal" => "1034" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19891056" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0280" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mutational signatures associated with tobacco smoking in human cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L.B. Alexandrov" 1 => "Y.S. Ju" 2 => "K. Haase" 3 => "P. van Loo" 4 => "I. Martincorena" 5 => "S. Nik-Zainal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1126/science.aag0299" "Revista" => array:6 [ "tituloSerie" => "Science" "fecha" => "2016" "volumen" => "354" "paginaInicial" => "618" "paginaFinal" => "622" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27811275" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0285" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contribution of tobacco and alcohol to the high rates of squamous cell carcinoma of the supraglottis and glottis in Central Europe" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Hashibe" 1 => "P. Bofetta" 2 => "D. Zaridze" 3 => "O. Shangina" 4 => "N. Szeszenia-Dabrowska" 5 => "D. Mates" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/aje/kwk066" "Revista" => array:6 [ "tituloSerie" => "Am J Epidemiol" "fecha" => "2007" "volumen" => "165" "paginaInicial" => "814" "paginaFinal" => "820" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17244634" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0290" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Associations of duration, intensity, and quaintly of smoking with adenocarcimona and squamous cell carcinoma of the esophagus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N. Pandeya" 1 => "G.M. Williams" 2 => "S. Sadhegi" 3 => "A.C. Green" 4 => "P.W. Webb" 5 => "D.C. Whiteman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/aje/kwn091" "Revista" => array:6 [ "tituloSerie" => "Am J Epidemiol" "fecha" => "2008" "volumen" => "168" "paginaInicial" => "105" "paginaFinal" => "114" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18483122" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0295" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "History of urinary tract infection and risk of renal cell carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.S. Parker" 1 => "J.R. Cerhan" 2 => "C.F. Lynch" 3 => "B.C. Leibovich" 4 => "K.P. Cantor" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Epidemiol" "fecha" => "2004" "volumen" => "159" "paginaInicial" => "42" "paginaFinal" => "48" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14693658" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0300" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Identification of tobacco-specific carcinogen in the cervical mucus of smokers and nonsmokers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B. Prokopczyk" 1 => "J.E. Cox" 2 => "D. Hoffman" 3 => "S.E. Waggoner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Natl Cancer Inst" "fecha" => "1997" "volumen" => "89" "paginaInicial" => "863" "paginaFinal" => "873" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9196252" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0305" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The pathology of smoking-related lung diseases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.C. Aubry" 1 => "J.L. Wright" 2 => "J.L. Myers" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Chest Med" "fecha" => "2000" "volumen" => "21" "paginaInicial" => "11" "paginaFinal" => "35" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10763087" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0310" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Proportion of community-acquired pneumonia cases attributable to tobacco smoking" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Almirall" 1 => "C.A. Gonzalez" 2 => "X. Balanzó" 3 => "I. Bolibar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1999" "volumen" => "116" "paginaInicial" => "375" "paginaFinal" => "379" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10453865" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0315" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "GOLD Scientific Committee Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R.A. Pauwels" 1 => "A.S. Buist" 2 => "P.M. Calverley" 3 => "C.R. Jenkins" 4 => "S.S. Hurd" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm.163.5.2101039" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2001" "volumen" => "163" "paginaInicial" => "1256" "paginaFinal" => "1276" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11316667" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0320" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "EPOC y cáncer de pulmón" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "E. Barreiro" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2008" "volumen" => "44" "paginaInicial" => "399" "paginaFinal" => "401" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18775249" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0325" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A common familial component in lung cancer and chronic obstructive pulmonary disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.H. Cohen" 1 => "E.L. Diamond" 2 => "C.G. Graves" 3 => "P. Kreiss" 4 => "D.A. Levy" 5 => "H.A. Menkes" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S2213-2600(14)70148-1" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "1997" "volumen" => "2" "paginaInicial" => "523" "paginaFinal" => "536" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25008952" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0330" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relationships between chronic obstructive pulmonary disease and lung cancer: biological insights" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E. Barreiro" 1 => "V. Bustamante" 2 => "V. Curull" 3 => "J. Gea" 4 => "J.L. López-Campos" 5 => "X. Muñoz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.21037/jtd.2016.09.54" "Revista" => array:6 [ "tituloSerie" => "J Thorac Dis" "fecha" => "2016" "volumen" => "8" "paginaInicial" => "E1122" "paginaFinal" => "E1135" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27867578" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0335" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Higher risk of lung cancer in chronic obstructive pulmonary disease. A prospective, matched, controlled study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.M. Skillrud" 1 => "K.P. Oxford" 2 => "R.D. Millar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "1866" "volumen" => "105" "paginaInicial" => "503" "paginaFinal" => "507" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3752756" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0340" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Low lung function and incident lung cancer in the United States: data from First National Health and Nutrition Examination Survey follow-up" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D.M. Mannino" 1 => "S.M. Aguayo" 2 => "T.L. Petty" 3 => "S.C. Redd" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archinte.163.12.1475" "Revista" => array:6 [ "tituloSerie" => "Arch Intern Med" "fecha" => "2003" "volumen" => "163" "paginaInicial" => "1475" "paginaFinal" => "1480" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12824098" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0345" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prospective study of pulmonary function and lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Nomura" 1 => "G.N. Stemmermann" 2 => "P.H. Chyou" 3 => "E.B. Marcus" 4 => "A.S. Buist" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm/144.2.307" "Revista" => array:6 [ "tituloSerie" => "Am Rev Respir Dis" "fecha" => "1991" "volumen" => "144" "paginaInicial" => "307" "paginaFinal" => "311" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1859052" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0350" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "COPD prevalence is increased in lung cancer independent of age, gender and smoking history" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R.P. Young" 1 => "R.J. Hopkins" 2 => "T. Christmas" 3 => "P.N. Black" 4 => "P. Metcalf" 5 => "G.D. Gamble" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00144208" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2009" "volumen" => "34" "paginaInicial" => "380" "paginaFinal" => "386" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19196816" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0355" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lung cancer in patients with chronic obstructive pulmonary disease — incidence and predicting factors" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.P. De Torres" 1 => "J.M. Marín" 2 => "C. Casanova" 3 => "C. Cote" 4 => "S. Carrizo" 5 => "E. Cordoba-Lanus" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.201103-0430OC" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2011" "volumen" => "184" "paginaInicial" => "913" "paginaFinal" => "919" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21799072" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0360" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of smoking intervention and the use of an inhaled anticholinergic bronchodilator on the rate of decline of FEV1: the Lung Health Study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N.R. Anthonisen" 1 => "J.E. Connett" 2 => "J.P. Kiley" 3 => "M.D. Altose" 4 => "W.C. Bailey" 5 => "A.S. Buist" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "1994" "volumen" => "272" "paginaInicial" => "1497" "paginaFinal" => "1505" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7966841" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0365" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Airways obstruction and the risk for lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.S. Tockman" 1 => "N.R. Anthonisen" 2 => "E.C. Wright" 3 => "M.G. Donithan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "1987" "volumen" => "106" "paginaInicial" => "512" "paginaFinal" => "518" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3826952" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0370" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessing the relationship between lung cancer risk and emphysema detected on low-dose CT of the chest" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.P. De Torres" 1 => "G. Bastarrika" 2 => "J.P. Wisnivesky" 3 => "A.B. Alcaide" 4 => "A. Campo" 5 => "L.M. Seijo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.07-1490" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2007" "volumen" => "132" "paginaInicial" => "1932" "paginaFinal" => "1938" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18079226" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0375" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association of radiographic emphysema and airflow obstruction with lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.O. Wilson" 1 => "J.L. Weissfeld" 2 => "A. Balkan" 3 => "J.G. Schragin" 4 => "C.R. Fuhrman" 5 => "S.N. Fisher" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.200803-435OC" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2008" "volumen" => "178" "paginaInicial" => "738" "paginaFinal" => "744" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18565949" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0380" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Previous lung disease and lung cancer risk: a systematic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.R. Brenner" 1 => "J.R. McLaughlin" 2 => "R.J. Hung" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pone.0017479" "Revista" => array:5 [ "tituloSerie" => "PLOS ONE" "fecha" => "2011" "volumen" => "6" "paginaInicial" => "e17479" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21483846" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0385" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "CT screening for lung cancer: importance of emphysema for never smokers and smokers" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.I. Henschke" 1 => "R. Yip" 2 => "P. Boffetta" 3 => "S. Markowitz" 4 => "A. Miller" 5 => "T. Hanaoka" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.lungcan.2015.01.014" "Revista" => array:6 [ "tituloSerie" => "Lung Cancer" "fecha" => "2015" "volumen" => "88" "paginaInicial" => "42" "paginaFinal" => "47" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25698134" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0390" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic obstructive pulmonary disease is associated with lung cancer mortality in a prospective study of never smokers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.C. Turner" 1 => "Y. Chen" 2 => "D. Krewski" 3 => "E.E. Calle" 4 => "M.J. Thun" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.200612-1792OC" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2007" "volumen" => "176" "paginaInicial" => "285" "paginaFinal" => "290" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17478615" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0395" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk of cancers in COPD patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Nakayama" 1 => "H. Satoh" 2 => "K. Sekizawa" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2003" "volumen" => "123" "paginaInicial" => "1775" "paginaFinal" => "1776" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12740308" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0400" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impaired lung function and lung cancer incidence in a cohort of Swedish construction workers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.P. Purdue" 1 => "L. Gold" 2 => "B. Jarvholm" 3 => "M.C. Alavanja" 4 => "M.H. Ward" 5 => "R. Vermeulen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/thx.2006.064196" "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "2007" "volumen" => "62" "paginaInicial" => "51" "paginaFinal" => "56" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16928722" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0405" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spectrum of cancer risk among Taiwanese with chronic obstructive pulmonary disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.L. Chiang" 1 => "Y.W. Hu" 2 => "C.H. Wu" 3 => "Y.T. Chen" 4 => "C.J. Liu" 5 => "Y.H. Lou" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10147-016-0983-z" "Revista" => array:6 [ "tituloSerie" => "Int J Clin Oncol" "fecha" => "2016" "volumen" => "21" "paginaInicial" => "1014" "paginaFinal" => "1020" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27154177" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0410" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic obstructive pulmonary disease and cancer risk: a Danish nationwide cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.B. Kornum" 1 => "C. Sværke" 2 => "R.W. Thomsen" 3 => "P. Lange" 4 => "H.T. Sørensen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rmed.2011.12.009" "Revista" => array:6 [ "tituloSerie" => "Respir Med" "fecha" => "2012" "volumen" => "106" "paginaInicial" => "845" "paginaFinal" => "852" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22214771" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0415" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incidence and relative risk for developing cancer among patients with COPD: a nationwide cohort study in Taiwan" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C.H. Ho" 1 => "Y.C. Chen" 2 => "J.J. Wang" 3 => "K.M. Liao" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmjopen-2016-013195" "Revista" => array:5 [ "tituloSerie" => "BMJ Open" "fecha" => "2017" "volumen" => "7" "paginaInicial" => "e013195" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28279996" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0420" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of colorectal adenomatous polyps in patients with chronic obstructive pulmonary disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E.M. Chun" 1 => "S.W. Kim" 2 => "S.Y. Lim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2147/COPD.S83341" "Revista" => array:6 [ "tituloSerie" => "Int J Chron Obstruct Pulmon Dis" "fecha" => "2015" "volumen" => "10" "paginaInicial" => "955" "paginaFinal" => "960" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26028968" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0425" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inflammation in the genesis and perpetuation of cancer: summary and recommendations from a national cancer institute-sponsored meeting" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.M Peek Jr." 1 => "S. Mohla" 2 => "R.N. DuBois" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1158/0008-5472.CAN-05-1777" "Revista" => array:6 [ "tituloSerie" => "Cancer Res" "fecha" => "2005" "volumen" => "65" "paginaInicial" => "8583" "paginaFinal" => "8586" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16204020" "web" => "Medline" ] ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0430" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The potential contributions of chronic inflammation to lung carcinogenesis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Ballaz" 1 => "J.L. Mulshine" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3816/CLC.2003.n.021" "Revista" => array:6 [ "tituloSerie" => "Clin Lung Cancer" "fecha" => "2003" "volumen" => "5" "paginaInicial" => "46" "paginaFinal" => "62" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14596704" "web" => "Medline" ] ] ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib0435" "etiqueta" => "38" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inflammation and cancer: role of phagocyte-generated oxidants in carcinogenesis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.A. Weitzman" 1 => "L.I. Gordon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "1990" "volumen" => "76" "paginaInicial" => "655" "paginaFinal" => "663" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2200535" "web" => "Medline" ] ] ] ] ] ] ] ] 38 => array:3 [ "identificador" => "bib0440" "etiqueta" => "39" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Link between COPD and lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.P. Young" 1 => "R.J. Hopkins" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rmed.2009.11.025" "Revista" => array:6 [ "tituloSerie" => "Respir Med" "fecha" => "2010" "volumen" => "104" "paginaInicial" => "758" "paginaFinal" => "759" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20226648" "web" => "Medline" ] ] ] ] ] ] ] ] 39 => array:3 [ "identificador" => "bib0445" "etiqueta" => "40" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ascertainment of cause-specific mortality in COPD: operations of the TORCH Clinical Endpoint Committee" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "TORCH Clinical Endpoint Committee" "etal" => false "autores" => array:5 [ 0 => "L.P. McGarvey" 1 => "M. John" 2 => "J.A. Anderson" 3 => "M. Zvarich" 4 => "R.A. Wise" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/thx.2006.072348" "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "2007" "volumen" => "62" "paginaInicial" => "411" "paginaFinal" => "415" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17311843" "web" => "Medline" ] ] ] ] ] ] ] ] 40 => array:3 [ "identificador" => "bib0450" "etiqueta" => "41" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Global strategy for the diagnosis, management and prevention of COPD, global initiative for chronic obstructive lung disease (GOLD); 2009. Available from: <a href="http://www.goldcopd.org/">http://www.goldcopd.org</a>." ] ] ] 41 => array:3 [ "identificador" => "bib0455" "etiqueta" => "42" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Global strategy for the diagnosis, management and prevention of COPD, global initiative for chronic obstructive lung disease (GOLD); 2017. Available from: <a href="http://www.goldcopd.org/">http://www.goldcopd.org</a>." ] ] ] 42 => array:3 [ "identificador" => "bib0460" "etiqueta" => "43" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trends in tobacco smoking and mortality from cigarette use in cancer prevention studies I (1959–1965) and II (1982–1988)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.J. Thun" 1 => "C. Day-Lally" 2 => "D.G. Myers" 3 => "E.E. Calle" 4 => "W.D. Flanders" 5 => "B.P. Zhu" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:6 [ "titulo" => "Changes in cigarette related disease risks and their implication for prevention and control (Smoking and Tobacco Control Monograph No. 8; NIH Publication No. 97-4231)" "fecha" => "1997" "paginaInicial" => "305" "paginaFinal" => "382" "editorial" => "US Government Printing Office" "editorialLocalizacion" => "Bethesda, MD" ] ] ] ] ] ] 43 => array:3 [ "identificador" => "bib0465" "etiqueta" => "44" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology of lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.J. Alberg" 1 => "J.M. Samet" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Chest" "fecha" => "2003" "volumen" => "123" "numero" => "Suppl." "paginaInicial" => "21S" "paginaFinal" => "49S" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12527563" "web" => "Medline" ] ] ] ] ] ] ] ] 44 => array:3 [ "identificador" => "bib0470" "etiqueta" => "45" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cigarette smoking and bronchial carcinoma: dose and time relationships among regular smokers and lifelong non-smokers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Doll" 1 => "R. Peto" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Epidemiol Commun Health" "fecha" => "1978" "volumen" => "32" "paginaInicial" => "303" "paginaFinal" => "313" ] ] ] ] ] ] 45 => array:3 [ "identificador" => "bib0475" "etiqueta" => "46" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Profile of endocrinological derangements affecting PSA values in patients with COPD" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E. Karakou" 1 => "C. Glynos" 2 => "K.D. Samara" 3 => "P. Msaouel" 4 => "M. Koutsilieris" 5 => "T. Vassilakopoulos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "In Vivo" "fecha" => "2013" "volumen" => "27" "paginaInicial" => "641" "paginaFinal" => "649" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23988900" "web" => "Medline" ] ] ] ] ] ] ] ] 46 => array:3 [ "identificador" => "bib0480" "etiqueta" => "47" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association of visceral obesity and early colorectal neoplasia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E.K. Choe" 1 => "D. Kim" 2 => "H.J. Kim" 3 => "K.J. Park" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3748/wjg.v19.i45.8349" "Revista" => array:6 [ "tituloSerie" => "World J Gastroenterol" "fecha" => "2013" "volumen" => "19" "paginaInicial" => "8349" "paginaFinal" => "8356" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24363527" "web" => "Medline" ] ] ] ] ] ] ] ] 47 => array:3 [ "identificador" => "bib0485" "etiqueta" => "48" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dietary patterns and risk of colorectal cancer: analysis by tumor location and molecular subtypes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.S. Mehta" 1 => "M. Song" 2 => "R. Nishihara" 3 => "D.A. Drew" 4 => "K. Wu" 5 => "Z.R. Qian" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.gastro.2017.02.015" "Revista" => array:6 [ "tituloSerie" => "Gastroenterology" "fecha" => "2017" "volumen" => "152" "paginaInicial" => "1944" "paginaFinal" => "1953.e1" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28249812" "web" => "Medline" ] ] ] ] ] ] ] ] 48 => array:3 [ "identificador" => "bib0490" "etiqueta" => "49" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epigenetics of lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.V. Bowman" 1 => "I.A. Yang" 2 => "A.B. Semmler" 3 => "K.M. Fong" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1440-1843.2006.00859.x" "Revista" => array:6 [ "tituloSerie" => "Respirology" "fecha" => "2006" "volumen" => "11" "paginaInicial" => "355" "paginaFinal" => "365" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16771905" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000021700000007/v1_201709280051/S2254887417300942/v1_201709280051/en/main.assets" "Apartado" => array:4 [ "identificador" => "1901" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000021700000007/v1_201709280051/S2254887417300942/v1_201709280051/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887417300942?idApp=WRCEE" ]
