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Chronic Obstructive Pulmonary Disease and Subsequent Overall and Lung Cancer Mortality in Low-Income Adults

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  • Melinda C Aldrich
  • Heather M Munro
  • Michael Mumma
  • Eric L Grogan
  • Pierre P Massion
  • Timothy S Blackwell
  • William J Blot

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a known risk factor for lung cancer and a leading cause of mortality in the U.S., but its impact may not be fully appreciated, especially among low-income populations in the southeast where COPD prevalence and lung cancer incidence are elevated. Methods: We conducted a prospective study among 26,927 low-income adults age 40–79 in the Southern Community Cohort Study who had a Center for Medicare and Medicaid Services (CMS) encounter prior to enrollment and were followed for a median of over 6 years. Using a validated algorithm for assessing COPD from CMS claims data, we estimated COPD prevalence and potential misreporting. From Cox proportional hazard models, we computed overall and lung cancer-specific mortality according to COPD status. Results: The overall prevalence of CMS-diagnosed COPD was 16%, but was twice as high among whites as blacks. Only 35% of these individuals, however, self-reported having COPD, with underreporting significantly greater for blacks than whites. Smoking-adjusted all-cause mortality was increased by 1.7-fold and lung cancer mortality by 2.3-fold among those with a CMS COPD diagnosis, with similar patterns in blacks and whites, but no excess was found among those self-reporting COPD and without CMS confirmation. Conclusion: The prevalence of COPD in this low-income population may be greater than previously recognized and misreporting is common. COPD is associated with elevated lung cancer mortality, even among those not self-reporting the condition.

Suggested Citation

  • Melinda C Aldrich & Heather M Munro & Michael Mumma & Eric L Grogan & Pierre P Massion & Timothy S Blackwell & William J Blot, 2015. "Chronic Obstructive Pulmonary Disease and Subsequent Overall and Lung Cancer Mortality in Low-Income Adults," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-14, March.
  • Handle: RePEc:plo:pone00:0121805
    DOI: 10.1371/journal.pone.0121805
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    1. Cassandra Willyard, 2012. "Diagnosis: To catch a killer," Nature, Nature, vol. 489(7417), pages 8-9, September.
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    1. Dimitra Sifaki-Pistolla & Vasiliki Eirini Chatzea & Enkeleint A. Mechili & Filippos Koinis & Vassilis Georgoulias & Christos Lionis & Nikos Tzanakis, 2022. "Spatio-Temporal Variation of Lung Cancer in Crete, 1992–2013. Economic or Health Crisis?," IJERPH, MDPI, vol. 19(19), pages 1-10, September.

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