ArticleThorax2016
Per cent emphysema is associated with respiratory and lung cancer mortality in the general population: a cohort study.
Article in Thorax, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 2 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- The Use of Computed Tomography Densitometry for the Assessment of Emphysema in Clinical Trials: A Position Paper from the Fleischner Society.American journal of respiratory and critical care medicine · 2025Pooled it
- Prevalence of lung cancer in chronic obstructive pulmonary disease: A systematic review and meta-analysis.Frontiers in oncology · 2022Pooled it
- Association of AI-Derived Quantitative CT Parameters of Airway, Emphysema, and Pulmonary Vasculature with Lung Cancer: A Cross-Sectional AnalysisCurrent medical imaging · 2026Article
- Article
- Proteomic discovery analysis of quantitatively assessed emphysema in the general population. The MESA Lung Study.Respiratory research · 2025Article
- Dementia Deaths Most Commonly Result from Heart and Lung Disease: Evidence from the South Carolina Alzheimer's Disease Registry.Biomedicines · 2025Article
- Article
- COPD is associated with increased cardiovascular disease risk independent of phenotype.Respirology (Carlton, Vic.) · 2024Article
- Malnutrition and Obesity in Patients with COPD Exacerbation, Insights from the National Inpatient Sample.The open respiratory medicine journal · 2024Article
- Article
- The relationship of airflow limitation with lung squamous cell carcinoma: evidence from mendelian randomization analysis.Journal of cancer research and clinical oncology · 2023Article
- Review
- Stratification of Lung Cancer Risk with Thoracic Imaging Phenotypes.Proceedings of SPIE--the International Society for Optical Engineering · 2023Article
- Obesity Paradox in Lung Diseases: What Explains It?Obesity facts · 2023Review
- Quantitative evaluation of emphysema for predicting immunotherapy response in patients with advanced non-small-cell lung cancer.Scientific reports · 2022Article
- Race/Ethnicity, Spirometry Reference Equations, and Prediction of Incident Clinical Events: The Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study.American journal of respiratory and critical care medicine · 2022Article
- Article
- Comparison of CT Lung Density Measurements between Standard Full-Dose and Reduced-Dose Protocols.Radiology. Cardiothoracic imaging · 2021Article
- Lung emphysema and lung cancer: what do we know about it?Annals of translational medicine · 2020Review
- Lung function in men with and without HIV.AIDS (London, England) · 2020Observational
Corrections and comments
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Authors and funding
13 authors at 9 institutions in 2 countries.
Funding
Abstract
backgroundEmphysema on CT is a risk factor for all-cause mortality in persons with and without airflow obstruction; however, causes of death associated with emphysema remain uncertain, particularly in the general population.
aimsTo test associations between quantitatively assessed emphysema on CT and cause of death in persons with and without a substantial smoking history.
methodsThe Multi-Ethnic Study of Atherosclerosis recruited 6814 participants, aged 45-84 years and without clinical cardiovascular disease, in 2000-2002. Per cent emphysema was defined on cardiac CT as per cent of lung voxels less than -950 Hounsfield units; emphysema on CT was defined as per cent emphysema above the upper limit of normal. Cause of death was classified by administrative codes. Proportional-hazards models were adjusted for age, race/ethnicity, gender, body mass index, smoking status, pack-years, coronary artery calcium, site and education. Additional adjustment for lung function was made in a subset with spirometry from 2004 to 2006.
resultsThere were 1091 deaths over 12 years median follow-up. Emphysema on CT was strongly associated with increased mortality due to respiratory diseases (adjusted HR 2.94, 95% CI 1.68 to 5.15), particularly chronic lower respiratory diseases (adjusted HR 9.54, 95% CI 4.70 to 19.35), and lung cancer (adjusted HR 1.84, 95% CI 1.09 to 3.12), but not cardiovascular disease. Associations persisted among participants with fewer than 10 pack-years and those without physician-diagnosed respiratory disease, and were similar after adjustment for airflow measures and in persons without airflow limitation.
conclusionsQuantitatively assessed emphysema on CT is associated with greater respiratory disease and lung cancer mortality, even among persons without traditional risk factors.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.