TY - JOUR T1 - Lung function predicts lung cancer risk in smokers: a tool for targeting screening programmes JF - European Respiratory Journal JO - Eur Respir J SP - 146 LP - 151 DO - 10.1183/09031936.00049909 VL - 35 IS - 1 AU - E. Calabrò AU - G. Randi AU - C. La Vecchia AU - N. Sverzellati AU - A. Marchianò AU - M. Villani AU - M. Zompatori AU - R. Cassandro AU - S. Harari AU - U. Pastorino Y1 - 2010/01/01 UR - http://erj.ersjournals.com/content/35/1/146.abstract N2 - The relationship between smoking, lung cancer and airflow obstruction is recognised but it is unclear whether the presence of minimal lung function damage constitutes an independent risk factor for the development of lung cancer. In order to identify those individuals at higher risk of lung cancer on the basis of functional impairment, we evaluated baseline pulmonary function tests of 3,806 heavy smokers undergoing annual chest computed tomography screening, and compared the forced expiratory volume in 1 s (FEV1) % predicted of 57 lung cancer cases and that of 3,749 subjects without cancer. We obtained odds ratios (ORs) of lung cancer and the corresponding 95% confidence intervals (CIs) using unconditional logistic regression, adjusting for age, sex, study and smoking variables. Compared with subjects with FEV1 ≥90% pred, the OR of lung cancer was 2.45 (95% CI 1.39–4.33) for subjects with FEV1 <90% pred and 2.90 (95% CI 1.34–6.27) for subjects with FEV1 <70% pred. These data show that even a relatively small reduction in FEV1 % pred is a significant predictor of increased lung cancer risk. Test screening for lung cancer using airflow obstruction with FEV1 <90% is a strategy worth future consideration. ER -