Emphysema, COPD and smoking burden among lung cancer survivors with a second primary lung cancer compared with patients with just one primary lung cancer.

Emphysema and tobacco are the main risk factors for lung cancer (LC). We aimed to analyze the presence of emphysema, smoking burden and COPD in patients who develop a SPLC compared with patients with just one primary LC. <bold>Methods:</bold> Patients from the Pamplona International Early Lung Cancer Detection Program (P-IELCAP) cohort from 2000-2023 were studied. We analyzed the smoking burden, emphysema and COPD as for the diagnosis of a SPLC. Xi2 test was performed. <bold>Results:</bold> 491 patients with resected LC were studied. 35 (7,1%) developed a SPLC (group A) and 456 had just one primary LC (group B). 65,7% of the patients in group A had COPD vs. 44% in group B. Presence of COPD was significantly higher in group A (Xi2, p=0,010). 63% of the patients in group A had emphysema vs. 48% in group B. There was a numerically higher frequency of emphysema in group A, although it was not statistically significant. Smoking burden was 48.8 p-y for group A and 41.5 p-y for group B. There were no significant differences between groups. Distribution as for stage at diagnosis for both groups is shown in the figure. <fig><object-id>erj;64/suppl_68/PA4208/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <bold>Conclusions:</bold> We observed an association between the presence of COPD and the diagnosis of second primary lung tumors in lung cancer patients following screening programs. More than half of the second primary tumors were diagnosed at early stages.