Patients hospitalized with severe COVID-19 have an increased risk of developing lung cancer, months or years later, according to new research from University of Virginia.
Patients hospitalized with severe COVID-19 have an increased risk of developing lung cancer months or years later, according to new research from the University of Virginia.
U.Va. School of Medicine researcher Jie Sun and his colleagues found serious viral infections “reprogrammed” immune cells in the lungs to facilitate the growth of cancer tumors, up to years later.
“A bad case of COVID or flu can leave the lungs in a long-lasting ‘inflamed’ state that makes it easier for cancer to take hold later,” Sun said. “The encouraging news is that vaccination largely prevents those harmful changes for cancer growth in the lung.”
While respiratory infections, including flu and COVID, have been known causes of injury and trauma to the lung, it hasn’t been clear what effect those injuries have on long-term cancer risk.
Sun and his team examined the effects on both lab mice and human patients, in research from U.Va. Health’s Beirne B. Carter Center for Immunology Research and the U.Va. Comprehensive Cancer Center. Their findings were published in the scientific journal Cell.
Mice that suffered severe lung infections were both more likely to go on to develop lung cancer and significantly more likely to die from the disease.
When the researchers examined data from patients, the findings held true.
“The scientists found a significant association between prior COVID-19 hospitalization and increased lung cancer incidence,” according to a news release. “This 1.24-fold increase held true regardless of whether the patients were smokers or had other health conditions,” known as comorbidities.
In other words, after a serious COVID-19 infection, the chances of developing lung cancer in the future is roughly one-quarter higher than normal.
According to the researchers, prior vaccination appeared to prevent the cancer-promoting lung changes, since vaccines train the immune system to battle infections, reducing the severity of the illness.
The increased cancer risk was seen only in patients with severe COVID; those who suffered mild cases actually saw a slight decrease in risk.
After severe COVID, regular screening can prevent lung cancer
With tens of millions of people globally experiencing long-term pulmonary effects from COVID, the U.Va. researchers hope their findings will help doctors identify patients at risk for viral lung cancer, so they can get treatment sooner.
“Our goal is to help doctors identify who may be at higher risk of lung cancer after prior pneumonia,” said Sun, who said vaccines don’t just prevent acute hospitalization after contracting pneumonia. “They may also reduce the long-term fallout of severe infection, including the kind of immune scarring that can increase cancer risk.”
Jeffrey Sturek, U.Va. physician-scientist and collaborator on the project, said the findings suggest more aggressive surveillance is needed.
“We’ve known for a long time that things like smoking increase the risk of lung cancer,” Sturek said. “The results from this study suggest that we may need to think about severe respiratory viral infection similarly.”
For patients who are considered high risk because of a smoking history, doctors recommend regular CT screenings to catch cancer early.
“In future studies, we may want to consider a similar approach after severe respiratory viral infection,” Sturek said.
“Individuals recovering from severe viral pneumonia, particularly those with smoking history, may benefit from enhanced lung cancer surveillance, and preventing severe lung infection through vaccination may confer indirect cancer protection benefits,” Sun said.
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