Researchers from several U.S. medical centers have reported that 9% of patients hospitalized with pneumonia were diagnosed with pulmonary malignancy, but the median time from hospitalization to diagnosis is 297 days. The details of this study were published in the January 2010 issue of the American Journal of Medicine.[1]

Patients with lung cancer or metastatic cancers to the lung often develop pneumonia as the first clinical sign of disease. However, the incidence of pulmonary malignancies in patients with pneumonia has not been determined.

Researchers involved in the current study evaluated the incidence of pulmonary malignancies in 40,744 patients hospitalized with pneumonia. The median time to diagnosis of pulmonary malignancy was 297 days. Only 27% of patients were diagnosed with pulmonary malignancy within 90 days of admission for pneumonia.

Factors significantly associated with malignancy included:

• History of chronic pulmonary disease
• Any prior malignancy
• White race
• Being married
• Tobacco use

Factors associated with a lower risk of malignancy included:

• Increasing age
• Hispanic ethnicity
• Need for intensive care
• History of congestive heart failure
• Stroke
• Dementia
• Complications of diabetes

These authors concluded: “Additional research is needed to examine whether previously undiagnosed pulmonary malignancies might be detected at admission, or soon after, for those hospitalized with pneumonia.”

Comments: One simple screening technique would be to perform CT scans on all patients admitted for pneumonia.

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