Prevalence of Immune-mediated Inflammatory Diseases in Patients with Lung Cancer

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Background: Lung cancer is the leading cause of cancer death worldwide. Cigarette smoke remains the leading risk factor. In the last years, the association between immune-mediated inflammatory diseases (IMIDs) and bowel and hematological malignancies has been increasingly studied, but data on lung cancer are still lacking. Aims and objectives: To investigate the prevalence of IMIDs in patients with a new diagnosis of lung cancer. Methods This was a retrospective, cohort, real-life study, that enrolled patients who underwent a bronchoscopy in the Respiratory Disease Unit of Ospedale Luigi Sacco from January 2019 to December 2022. The specimen collected for the diagnosis included broncho-alveolar lavage (BAL), lymph-node transbronchial needle aspiration (TBNA) with or without endo-bronchial ultrasound (EBUS), bronchial brushing and endobronchial biopsies. Results: A total of 1059 patients were included (360 from 2019, 166 from 2020, 252 from 2021 and 281 from 2022). Lung cancer was diagnosed in 156 patients (14.7%): 70 (44.9%) with adenocarcinoma, 27 (17.3%) with squamous cell carcinoma, 11 (7.1%) with non-small cell lung cancer, 27 (17.3%) with small cell lung carcinoma and 21 (13.5%) had pulmonary metastases from different primary tumors. Among these patients, the prevalence of IMIDs was 6.4%, including 1 (0.6%) with rheumatoid arthritis, 5 (3.2%) with connective tissue disorders, 1 (0.6%) with inflammatory bowel diseases, 1 (0.6%) with a cutaneous inflammatory condition, and 2 (1.3%) with interstitial lung diseases. Conclusions: This study shows a possible association between IMIDs and lung cancer. Further studies are warranted to establish the potential increased risk of lung cancer in IMIDs.

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