06. Stacey Butler

Previously diagnosed and undiagnosed COPD among lung cancer patients in Ontario.


  • Helal Endisha says:

    Hi Stacey, very interesting study that underscores the need for early diagnosis of COPD particularly in the low income quintile. Have you looked at any associations between prescribed COPD treatments (in the previously diagnosed cohort) and survival in these lung cancer patients?

    • Stacey Butler says:

      Hi Helal,
      Thank you for your comment. That is an interesting idea to look at COPD related-prescriptions in the previously diagnosed cohort and survival. We would only be able to do this in those over the age of 65 with the data available through ICES. Previous research has shown COPD is associated with worse overall and disease-free survival, even in early stage lung cancer. It would be really interesting to see how their COPD was managed pharmacologically and how this impacts survival.

  • Tereza Martinu says:

    Great job, Stacey. I wonder whether some patients may have gotten misdiagnosed as asthma instead of COPD. Have you looked at that? Are there other comorbidities that you think co-exist with lung cancer?

    • Stacey Butler says:

      Hi Tereza, thank you for your question. It is possible that some may have been misdiagnosed with asthma, but the asthma percentage in the no COPD group is fairly low (8%). Our definition of COPD has shown good sensitivity and specificity but it is still possible to have some misdiagnosis.
      Yes other lung diseases, such as ILD, have also been shown to coexist with lung cancer. Given the strong association with smoking as well I think other diseases that are caused by smoking are also likely to be prevalent in this population. Since lung cancer also predominantly affects older adults, other chronic diseases that are common in older adults are likely to be present. Multimorbidity is definitely something to consider with lung cancer.

  • Matthew Binnie says:

    Hi Stacey. Nice work. Do you know about lung cancer screening in these patients? Are those with diagnosed COPD more likely to be screened? Are the previously diagnosed patients those for whom a COPD billing code was used? I wonder how many of them know they have COPD?

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