Incidence, treatment options, and outcomes of lung cancer in patients with chronic obstructive pulmonary disease

PURPOSE OF REVIEW: An associative and mechanistic link between chronic obstructive pulmonary disease (COPD) and lung cancer has long been suspected. This review describes the current understanding of the incidence, mechanism of association, treatment options, and outcome for lung cancer with COPD. RECENT FINDINGS: COPD patients have an increased risk of lung cancer that is independent of smoking. New evidence suggests that there is an inverse relationship between the severity of airflow obstruction and the risk of lung cancer. Chronic inflammation associated with COPD may play a role in the development of lung cancer, and targeting airway inflammation with inhaled corticosteroids has been suggested as a possible preventive strategy. Although surgical lobectomy remains the standard of care for early stage lung cancer, less invasive approaches such as sublobar resection, stereotactic body radiation therapy, and radiofrequency ablation are promising techniques for patients with limited pulmonary reserve. SUMMARY: Progress is being made in identifying mechanistic links between COPD and lung cancer, which may lead to novel therapeutic strategies for both disorders. Patients with COPD are likely to benefit from less-invasive surgical and nonsurgical treatment strategies for lung cancer, but further study is needed to determine the safety and efficacy of these procedures.