Prevalence, risk factors, and impact of lung cancer on outcomes of idiopathic pulmonary fibrosis: a study from the Middle East

Sherif Mohamed; Hassan Bayoumi; Nashwa Abd El-Aziz; Ehab Mousa; Yasser Gamal

doi:10.4081/mrm.2018.191

Prevalence, risk factors, and impact of lung cancer on outcomes of idiopathic pulmonary fibrosis: a study from the Middle East

Authors

Sherif Mohamed Department of Chest Diseases and Tuberculosis, Faculty of Medicine, Assiut University, Assiut http://orcid.org/0000-0001-9437-4799
Hassan Bayoumi Department of Chest Diseases and Tuberculosis, Faculty of Medicine, Assiut University, Assiut
Nashwa Abd El-Aziz Department of Medical Oncology, South Egypt Cancer Institute, Assiut University, Assiut
Ehab Mousa Department of Radiology, Faculty of Medicine, Assiut University, Assiut
Yasser Gamal Department of Pathology, Faculty of Medicine, Assiut University, Assiut

DOI: https://doi.org/10.4081/mrm.2018.191

Keywords:

Prevalence, Lung cancer, Idiopathic pulmonary fibrosis, Upper Egypt

Abstract

Background: No studies have addressed the impact of lung cancer (LC) on prognosis of patients with idiopathic pulmonary fibrosis (IPF) in Upper Egypt. We aimed to evaluate the prevalence and risk factors for LC among IPF patients and its impact on their outcomes and survival in Upper Egypt.

Methods: A total of 246 patients with IPF who had complete clinical and follow up data were reviewed. They were categorized into 2 groups: 34 patients with biopsy-proven LC and IPF (LC-IPF) and 212 patients with IPF only (IPF). Survival and clinical characteristics of the two groups were compared.

Results: Prevalence of LC was 13.8%. Pack/years was the most significant predictor for LC development in IPF (Odds ratio; 3.225, CI 1.257–1.669, p = 0.001). Survival in patients with LC-IPF was significantly worse than in patients with IPF without LC; median survival, 35 months vs 55 months; p = 0.000. LC accompanying IPF was one of the most significant independent predictors of survival in IPF patients (Hazard ratio 5.431, CI 2.186–13.492, p = 0.000). Mortality in LC-IPF patients was mainly due to LC progression in 36% and LC therapy-related complications in 22%.

Conclusions: Prevalence of LC in IPF patients was 13.8%. Lung cancer has significant impacts on patients with IPF in Upper Egypt, in terms of clinical outcomes and survival. Smoking is the most significant independent predictor of LC development in IPF patients. A poorer survival was observed for patients with IPF developing LC, mainly due to LC progression, and to complications of its therapies. Further prospective, multicenter and larger studies are warranted.