Lung cancer and abdominal aortic aneurysm (AAA) have several common risk factors. Considering that AAA is fatal, precise diagnosis and management of AAA would result in long-term survival benefit in patients with early lung cancer with good prognosis. We aimed to assess the prevalence and characteristics of AAA in patients with resectable non-small cell lung cancer (NSCLC).
Between January 2019 and November 2020, 1,019 patients with primary NSCLC treated surgically in Severance and Kangbuk Samsung Hospitals were reviewed retrospectively. We re-read abdominal-pelvic computed tomography (APCT) and positron emission tomography (PET) images and evaluated the presence of AAA. The control group comprised 2,899 cancer-free people who had a health check-up CT scan in Severance between January 2018 and December 2019. The Institutional Review Board and Ethics Committee of Severance Hospital approved this study (IRB number: 4–2021–1430).
Among patients with resectable primary NSCLC patients, 39/1,019 (3.8%; odds ratio [OR], 19.19; 95% confidence interval [CI], 8.10–46.46) had AAA compared with 6/2,899 (0.2%) in the control (P < 0.001). Smokers were more likely to have AAA than non-smokers (7.0% vs 0.8%; OR, 9.57; 95% CI, 3.38–27.14; P < 0.001). In multivariable regression analysis, male sex (OR, 13.24; 95% CI, 1.50–117.48; P = 0.020), older age (OR, 1.10; 95% CI, 1.04–1.15; P < 0.001), current smoker status (OR, 4.20; 95% CI, 1.20–14.62; P = 0.024), and coronary artery obstructive disease (OR, 3.13; 95% CI, 1.48–6.62; P = 0.003) were independent risk factors for AAA development in lung cancer.
In our real-world study, patients with early lung cancer has a significantly higher prevalence of AAA than cancer-free controls, indicating they are a high-risk group for AAA. Therefore, we suggest patients with early NSCLC, especially smokers older than 60 years, undergo regular AAA surveillance with long term post-op follow-up for not only lung cancer but also AAA.