Smaller lung volume linked to higher death risk in some smokers
Over a median five years, mortality reached 9.1% in smokers with one pattern of impaired lung function, versus 4.6% in those with normal results.
Our read
Biomarkers- Studied:
- Cohort study of 1,355 smokers with preserved ratio impaired spirometry, median 5·0 years
- What changed:
- Death risk was lower with each standard-deviation increase in lung volume among smokers with impaired breathing tests (hazard ratio 0·71)
- The catch:
- Differences in underlying health could contribute to the association between lung volume and mortality
Editor of record: Boris Djordjevic · AgingResearch.News
The 7,535 smokers aged 55–77 included 4,503 men and 3,032 women in a UK lung cancer screening cohort analyzed retrospectively in an observational study. Among them, 1,355 had preserved ratio impaired spirometry: reduced breathing-test performance despite a preserved ratio between two measurements of exhaled air.
The researchers measured total lung volume from low-dose computed tomography scans, adjusting for sex and body size. Within this subgroup, each standard-deviation increase in lung volume—a measure of variation between participants—was associated with lower mortality. The adjusted hazard ratio, which compares death rates over time, was 0.71. The link persisted after adjustment for the total amount of air participants could forcibly exhale.
Why it matters
Lung cancer screening in older smokers already produces scans that could also help assess broader health risks. The authors suggested using lung-volume measurements to identify people for confirmatory breathing tests and risk assessment.
Caveats
Differences in participants’ underlying health could have contributed to the association between lung volume and mortality. Participants came from a UK screening cohort, and the authors called for validation in other populations.
- Preserved ratio impaired spirometry
- Airflow obstruction
- Cardiometabolic disease
- CT-derived total lung volume
- Forced vital capacity
- Humans
The paper
The Lancet Medical Imaging & Theranostics, Nov 2026, Open access, CC BY
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