Increased risk of lung cancer in individuals with preserved ratio impaired spirometry: a nationwide cohort study

Abstract Accumulating data showed that individuals with preserved ratio impaired spirometry (PRISm) have an increased risk for all-cause mortality and respiratory-related mortality compared with normal spirometry. However, the association between PRISm and lung cancer development is not known. A ret...

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Main Authors: Taeyun Kim, Junsu Choe, Yunjoo Im, Jihye Heo, Hye Yun Park, Danbee Kang, Sun Hye Shin
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-05972-4
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author Taeyun Kim
Junsu Choe
Yunjoo Im
Jihye Heo
Hye Yun Park
Danbee Kang
Sun Hye Shin
author_facet Taeyun Kim
Junsu Choe
Yunjoo Im
Jihye Heo
Hye Yun Park
Danbee Kang
Sun Hye Shin
author_sort Taeyun Kim
collection DOAJ
description Abstract Accumulating data showed that individuals with preserved ratio impaired spirometry (PRISm) have an increased risk for all-cause mortality and respiratory-related mortality compared with normal spirometry. However, the association between PRISm and lung cancer development is not known. A retrospective cohort study was conducted using the Korean National Health and Nutrition Examination Survey data between 2007 and 2017, which was linked to the Health Insurance Review and Assessment database from 2007 to 2021. Men and women aged 40 to 79 years were categorized by baseline spirometry; PRISm (FEV1/FVC ≥ 0.7 and FEV1 < 80% pred), COPD (FEV1/FVC < 0.7) and normal spirometry (FEV1/FVC ≥ 0.7 and both FEV1 and FVC ≥ 80% pred). Incident lung cancer was defined as the presence of the International Classification of Diseases-10 C33 or C34 code. Among 26,490 individuals, 2628 (9.9%) and 3811 (14.4%) had PRISm and COPD, respectively. Compared to those with normal spirometry, those with PRISm were more likely female (72.0%) and never-smokers (70.2%). During the median follow-up of 10 years, individuals with PRISm (fully-adjusted HR = 1.83, 95% CI 1.25, 2.66) and COPD (fully-adjusted HR = 2.91, 95% CI 2.23, 3.80) had significantly higher risk of lung cancer than those with normal spirometry. The association between PRISm and lung cancer was more evident in ever smokers. This nationwide cohort study revealed that PRISm might be an independent risk factor for lung cancer development.
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spelling doaj-art-26b9e2c74e0d400ebfd4ff1b62e44d382025-08-20T03:45:26ZengNature PortfolioScientific Reports2045-23222025-07-011511910.1038/s41598-025-05972-4Increased risk of lung cancer in individuals with preserved ratio impaired spirometry: a nationwide cohort studyTaeyun Kim0Junsu Choe1Yunjoo Im2Jihye Heo3Hye Yun Park4Danbee Kang5Sun Hye Shin6Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDivision of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University College of MedicineCenter for Clinical Epidemiology, Samsung Medical CenterDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineCenter for Clinical Epidemiology, Samsung Medical CenterDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineAbstract Accumulating data showed that individuals with preserved ratio impaired spirometry (PRISm) have an increased risk for all-cause mortality and respiratory-related mortality compared with normal spirometry. However, the association between PRISm and lung cancer development is not known. A retrospective cohort study was conducted using the Korean National Health and Nutrition Examination Survey data between 2007 and 2017, which was linked to the Health Insurance Review and Assessment database from 2007 to 2021. Men and women aged 40 to 79 years were categorized by baseline spirometry; PRISm (FEV1/FVC ≥ 0.7 and FEV1 < 80% pred), COPD (FEV1/FVC < 0.7) and normal spirometry (FEV1/FVC ≥ 0.7 and both FEV1 and FVC ≥ 80% pred). Incident lung cancer was defined as the presence of the International Classification of Diseases-10 C33 or C34 code. Among 26,490 individuals, 2628 (9.9%) and 3811 (14.4%) had PRISm and COPD, respectively. Compared to those with normal spirometry, those with PRISm were more likely female (72.0%) and never-smokers (70.2%). During the median follow-up of 10 years, individuals with PRISm (fully-adjusted HR = 1.83, 95% CI 1.25, 2.66) and COPD (fully-adjusted HR = 2.91, 95% CI 2.23, 3.80) had significantly higher risk of lung cancer than those with normal spirometry. The association between PRISm and lung cancer was more evident in ever smokers. This nationwide cohort study revealed that PRISm might be an independent risk factor for lung cancer development.https://doi.org/10.1038/s41598-025-05972-4PRISmCOPDLung cancerSmoking
spellingShingle Taeyun Kim
Junsu Choe
Yunjoo Im
Jihye Heo
Hye Yun Park
Danbee Kang
Sun Hye Shin
Increased risk of lung cancer in individuals with preserved ratio impaired spirometry: a nationwide cohort study
Scientific Reports
PRISm
COPD
Lung cancer
Smoking
title Increased risk of lung cancer in individuals with preserved ratio impaired spirometry: a nationwide cohort study
title_full Increased risk of lung cancer in individuals with preserved ratio impaired spirometry: a nationwide cohort study
title_fullStr Increased risk of lung cancer in individuals with preserved ratio impaired spirometry: a nationwide cohort study
title_full_unstemmed Increased risk of lung cancer in individuals with preserved ratio impaired spirometry: a nationwide cohort study
title_short Increased risk of lung cancer in individuals with preserved ratio impaired spirometry: a nationwide cohort study
title_sort increased risk of lung cancer in individuals with preserved ratio impaired spirometry a nationwide cohort study
topic PRISm
COPD
Lung cancer
Smoking
url https://doi.org/10.1038/s41598-025-05972-4
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