The following is a summary of “Associations between chronic obstructive pulmonary disease and ten common cancers: novel insights from Mendelian randomization analyses,” published in the May 2024 issue of Oncology by Liao et al.

Chronic obstructive pulmonary disease (COPD) is a primary global health concern, potentially increasing the risk of various cancers. This study aimed to determine whether COPD is a risk marker or a causative factor for common cancers.

The researchers conducted univariable Mendelian randomization (UVMR) analyses to explore the causal relationship between COPD and the ten most prevalent cancers. Sensitivity analyses were performed to validate the primary findings. Additionally, multivariable Mendelian randomization (MVMR) and two-step Mendelian randomization (MR) analyses were employed. The false discovery rate (FDR) was utilized to correct for multiple testing biases.

UVMR analysis revealed significant associations between COPD and lung cancer (odds ratio [OR] = 1.42, 95% CI 1.15–1.77, FDR = 6.37 × 10^-3), extending to lung cancer subtypes such as squamous cell carcinoma (LUSC), adenocarcinoma (LUAD), and small cell lung cancer (SCLC). A potential association was also identified between COPD and bladder cancer (OR = 1.53, 95% CI 1.03–2.28, FDR = 0.125). However, no significant associations were found between COPD and other cancer types. The MVMR analysis, which adjusted for smoking, alcohol consumption, and body mass index, did not reveal significant causal relationships between COPD and either lung or bladder cancer. Nevertheless, the two-step MR analysis indicated that COPD mediated 19.2% (95% CI 12.7–26.1%), 36.1% (24.9–33.2%), 35.9% (25.7–34.9%), and 35.5% (26.2–34.8%) of the association between smoking and overall lung cancer, as well as LUAD, LUSC, and SCLC, respectively.

COPD appears to function more as a risk marker rather than a direct cause of prevalent cancers. Notably, it partially mediates the link between smoking and lung cancer, highlighting its significance in lung cancer prevention strategies.

Source: bmccancer.biomedcentral.com/articles/10.1186/s12885-024-12381-9