Does cryptogenic fibrosing alveolitis carry an increased risk of death from lung cancer?

Accepted for publication 24 April 1998 It is widely believed among chest physicians that patients with cryptogenic fibrosing alveo litis (CFA) are at substantially increased risk of death from lung cancer. This belief is largely the result of a follow up study by Turner Warwick and colleagues reported in 1980.1 Of 205 patients attending the Brompton Hospital between 1955 and 1973 with CFA, 20 (9.8%) died from lung cancer; an excess relative risk of 14.1. This association is often taken to suggest that pulmonary fibrosis in itself entails a mechanism that predisposes to malignancy and that this in turn may explain the observed risk between other fibrotic diseases such as asbest