Study objectives: To ascertain the frequency of diseases associated (comorbidity) with operable lung cancer (LC) globally, in relation to the presence of neoplastic clinical symptoms and age.
Design: Prospective; multi-institutional of 19 Spanish hospitals.
Patients: Two thousand nine hundred and ninety two consecutive cases of LC, treated surgically by the Bronchogenic Carcinoma Co-operative Group of the Spanish Society of Pneumology and Thoracic Surgery (GCCB-S) between 1993 and 1997, are analysed.
Methods: At time of treatment, data on the presence or absence of different specific comorbidities in all consecutive patients operated on for LC were entered on identical forms at all hospitals of the GCCB-S.
Results: In 2189 patients (73%) there was one or several comorbidities (chronic obstructive pulmonary disease [COPD], systemic arterial hypertension, previous tumour, cardiac disease, peripheral vascular disease or diabetes). Fifty percent of the LC was associated to COPD; in 32% of these patients with COPD, preoperative measurement of FEV1 was 70% below the theoretical value. In comparing the cases with symptoms ascribable to LC, it was found that in asymptomatic patients the presence of a previous tumour, arterial hypertension or cardiac disease was significantly more frequent. Conversely, in symptomatic patients, COPD was significantly more frequent. The frequency of all evaluated comorbidities is significantly higher in the older age groups.
Conclusions: In this multicenter study encompassing 2992 patients with operable LC, a high frequency of comorbidity has been found, COPD occurring most frequently. Certain diseases are more prevalent in asymptomatic patients, probably due to a screening bias. In older patients, there was a significant increase of all comorbidities.