Lung Cancer Risk in US Adults with COPD: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is an important risk factor for the development of, and death from, lung cancer. Methods: We conducted a systematic review and meta-analysis assessing the risk of lung cancer incidence and mortality among adults with a COPD diagnosis in the United States (US) and exploring differences by subgroups. We searched MEDLINE, Embase, and PubMed from inception to July 2024 for observational studies that investigated the association between COPD and lung cancer incidence and mortality risk. We conducted a meta-analysis for overall risk and COPD assessment methods, and a systematic review for analyses within sex, race/ethnicity, smoking status. Results: Twenty observational studies (n=638,610) were included in the systematic review and meta-analysis. US adults with COPD were found to have higher odds of developing (OR, 1.76; [1.53 to 1.99]) and higher hazards of dying (HR, 1.48; [1.06 to 1.89]) from lung cancer compared to those without COPD. Mixed results were observed when stratifying the impact of COPD on lung cancer risk by subgroups (ie, sex, race and ethnicity and smoking status). Generally, the same trend was observed where people in each subgroup with COPD were at higher risk of lung cancer incidence and mortality compared to those in the same subgroups without the disease. Individuals assessed by self-reported COPD and spirometry showed greater incidence risk but not mortality risk. Conclusion: US adults with COPD, including those with a smoking history, are at an increased risk for lung cancer incidence and mortality compared to those without COPD regardless of sex and race and ethnicity.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.007 | 0.002 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".