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David S. Ettinger, MD, FACP, FCCP


Do CT Assessments of Emphysema Suggest Higher Odds of Lung Cancer?

By: Joshua D. Madera, MS
Posted: Friday, May 27, 2022

For patients with emphysema, the increasing severity of the lung condition was found to be associated with higher odds of developing lung cancer, as determined by visual and quantitative CT assessments, according to a study published in Radiology. Increased rates of lung cancer were positively associated with centrilobular emphysema, explained Marleen Vonder, PhD, of the University Medical Center Groningen, the Netherlands, and colleagues.

“Our meta-analysis showed that not only visually assessed but also quantitatively assessed emphysema on CT is associated with lung cancer and that this risk increases for more severe emphysema,” commented Dr. Vonder in a press release from the Radiological Society of North America. “Other underlying mechanisms like genetic susceptibility, chronic inflammation, or DNA damage and abnormal repair mechanisms, or a combination thereof, have been proposed to link emphysema and lung cancer.”

Data from a total of 107,082 patients with emphysema from 21 studies were analyzed for this study. All studies were collected from PubMed, Cochrane, and Embase databases up until July 2021. Patients were stratified based on their disease severity and the subtype of their emphysema.

The study authors reported pooled odds ratios of 2.3 and 2.2 for studies with visual and quantitative assessments of emphysema, respectively. These odds ratios were comparable. In addition, as the severity of emphysema increased, the pooled odds ratio for lung cancer also increased. These odds ratios were increased for visual assessment compared with quantitative assessment in trace (2.5 vs. 1.9), mild (3.7 vs. 2.2), and moderate-to-severe (4.5 vs. 2.5) emphysema, respectively. Moreover, centrilobular emphysema alone was found to be associated with lung cancer, as compared with no emphysema (odds ratio = 2.2).

“Potentially, emphysema detected on a baseline CT scan could be used to select high-risk participants who would require more frequent follow-up lung cancer screening,” Dr. Vonder said.

Disclosure: For full disclosures of the study authors, visit

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