Spirometry, rapid FEV1 decline, and lung cancer among asbestos exposed heavy smokers

Abstract

We assessed whether spirometric measurements are associated with the development of accelerated FEV1 decline and lung cancer among active and previous smokers with a wide range of lung function. Bivariate and multivariate analyses that adjusted for age, intervention arm, smoking status at enrollment and smoking history, years exposed to asbestos, and evidence of asbestosis were used to assess whether baseline FEV1 and FEV 1/FVC ratio were associated with accelerated FEV1 decline and incident lung cancer. The 3,041 participants enrolled from 1985 to 1994 were followed through April 30, 2005. Baseline FEV1/FVC ratio < 0.7 was significantly associated with an increased risk for rapid lung function decline (OR = 1.73; 95% CI 1.31-2.28; p < 0.001). Baseline FEV 1/FVC ratio < 0.7 was also significantly associated with an increased risk of developing lung cancer, even when baseline FEV1 was > 80%. Lung cancer risk among participants with baseline airflow obstruction and FEV1 < 60% was 4-fold higher than participants without baseline airflow obstruction and FEV1 > 80% (p < 0.001), even among former smokers. These data indicate an FEV1/FVC < 0.7 among smokers is significantly associated with faster airflow loss, and an increased risk for developing lung cancer, even among those individuals with a normal FEV1. Copyright © 2007 Informa Healthcare USA, Inc.