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Published: 6 November 2015

Authors: Young, R.

Over the last 10 years there has been growing interest in the relationship between COPD and increased risk of lung cancer. Using molecular genetic approaches in epidemiological studies, we have shown that a smoker’s disposition to COPD may overlap with their predisposition to lung cancer. These observations suggest that factors including genetic predisposition and environmental factors other than smoking (eg, diet) may contribute to smokers developing respiratory complications.

In a study of smokers with lung cancer, we compared demographic variables and lung function tests between those with Māori and those with European ethnicity. Despite similar smoking exposure, we found that lung cancer in Māori was associated with younger age at diagnosis, greater airflow limitation (COPD tendency), more aggressive histology and a loss of the expected dose-response relationship between smoking intensity and lung function impairment. These observations suggest that Māori may be more susceptible to smoking, and that this may contribute to the significant difference in lung cancer incidence seen in Māori compared to European people.

We suggest strategies to promote the prevention, early diagnosis and treatment of lung cancer with Māori-specific interventions.