Do Patients with Bronchiectasis Have an Increased Risk of Developing Lung Cancer? A Systematic Review

SIMPLE SUMMARY: A growing amount of evidence points out that patients with chronic respiratory disease have an increased risk of lung cancer. We conducted a systematic review of all published data to define the characteristics of lung malignancies in patients with non-cystic fibrosis bronchiectasis and the characteristics of patients who develop bronchiectasis-associated lung cancer. The frequency rates of lung cancer in patients with non-cystic fibrosis bronchiectasis (NCFB) ranged from 0.93% to 8.0%. The incidence rate of lung cancer in bronchiectasis patients was 3.96, and adenocarcinoma was the most frequent histological type. The primary cause of death in the bronchiectasis group was malignancy (31.2%), particularly lung cancer (12.4%). We found that the presence of NCFB was associated with a higher risk of developing lung cancer than the population without NCFB, and this risk was higher for males, the elderly, and smokers. However, the effect of the co-existence of bronchiectasis and chronic obstructive pulmonary disease was unclear. ABSTRACT: Background: Initial evidence supports the hypothesis that patients with non-cystic fibrosis bronchiectasis (NCFB) have a higher risk of lung cancer. We systematically reviewed the available literature to define the characteristics of lung malignancies in patients with bronchiectasis and the characteristics of patients who develop bronchiectasis-associated lung cancer. Method: This study was performed based on the PRISMA guidelines. The review protocol was registered in PROSPERO. Results: The frequency rates of lung cancer in patients with NCFB ranged from 0.93% to 8.0%. The incidence rate was 3.96. Cancer more frequently occurred in the elderly and males. Three studies found an overall higher risk of developing lung cancer in the NCFB population compared to the non-bronchiectasis one, and adenocarcinoma was the most frequently reported histological type. The effect of the co-existence of NCFB and COPD was unclear. Conclusions: NCFB is associated with a higher risk of developing lung cancer than individuals without NCFB. This risk is higher for males, the elderly, and smokers, whereas concomitant COPD’s effect is unclear.