Dual protection in IPF: antifibrotic therapy and reduced lung cancer incidence- a systematic review and meta-analysis

Pirfenidone specifically may reduce lung cancer risk in IPF patients by 73-76%, though evidence is limited by observational designs, geographic restriction to East Asian populations, and biological heterogeneity between mechanistically distinct antifibrotic agents. Insufficient data exist for nintedanib. Agent-specific prospective randomized controlled trials are warranted. Protocol registration: PROSPERO identifier CRD420251119104.