November 17, 2025
Read
November 17, 2025

How COPD Increases Lung Cancer Risk and What You Can Do About It

Lung Health
,
Cancer
,
Reviewed By:
Dr Catherine Kennedy
,
How COPD Increases Lung Cancer Risk and What You Can Do About It

Contents

Table of contents placeholder

Living with COPD doesn’t just affect your breathing; it could be quietly increasing your risk of developing lung cancer. While many people know that smoking is the leading cause of both conditions, fewer realise that having COPD itself, regardless of smoking status, can raise their cancer risk. The overlap in symptoms can also make early signs easy to miss. In this article, we’ll break down how COPD and lung cancer are linked, what signs to watch for, and why proactive screening could make all the difference.

Chronic obstructive pulmonary disorder (COPD) is a progressive lung condition that blocks airflow and reduces lung function, often caused by long-term exposure to cigarette smoke. In the UK, around 1.4 million people have COPD, and having COPD increases lung cancer risk1. About 5 per cent of COPD patients develop lung cancer and face roughly four times the average risk, which contributes significantly to the over 33,000 annual lung cancer deaths in the UK2,3.

What is COPD?

As mentioned above, COPD is a progressive lung disease that includes both chronic bronchitis, characterised by long-term cough and phlegm production due to airway inflammation, and emphysema, which involves destruction of the tiny air sacs (alveoli) in the lungs4. 

The most common causes of COPD are cigarette smoking and long-term exposure to air pollution5. These inhaled irritants damage lung tissue and airways, leading to persistent breathing difficulty, cough, and increased risk of chest infections.

How COPD Damages the Lungs

Long-term COPD causes repeated airway inflammation and scarring that damages lung tissue, leading to destruction of alveoli, thickening and fibrosis of airway walls, and excessive mucus production6. 

Chronic exposure to irritants triggers immune cells to release inflammatory mediators and proteases, which break down lung structure and promote irreversible tissue remodelling7. These ongoing injuries increase susceptibility to cellular changes, such as epithelial senescence and DNA damage, raising the risk for cancerous transformations in the lung8.

Why COPD Patients are at Higher Risk of Lung Cancer

Multiple studies confirm that people with COPD have a much higher rate of lung cancer9. This increased risk is driven by ongoing biological changes: chronic airway inflammation and elevated oxidative stress trigger repeated lung cell damage, impair DNA repair mechanisms, and promote mutations and cellular ageing10. 

In COPD, inflammatory mediators, reactive oxygen species (ROS), and genetic/epigenetic alterations collectively create a lung environment that is highly susceptible to cancerous transformation11,12.

Symptoms to Watch For

Both COPD and lung cancer commonly cause13:

  • Persistent cough (sometimes with phlegm or blood).
  • Shortness of breath.
  • Wheezing.
  • Frequent chest infections.

These symptoms can worsen due to COPD progression or the development of lung cancer, so it is important not to dismiss new, persistent, or worsening signs; prompt medical evaluation can lead to earlier diagnosis and better outcomes.

Signs That May Indicate Cancer

Common warning signs include14:

  • Coughing up blood (even small amounts).
  • Persistent or worsening chest pain.
  • Unexplained weight loss.
  • A cough that does not go away after three weeks.
  • Shortness of breath or a change in the existing cough.
  • Hoarse voice.
  • Loss of appetite.
  • Increased fatigue or weakness.

You should contact your GP if you notice any of the above symptoms, especially coughing up blood, significant chest pain, or unexplained weight loss. Early evaluation improves the chances of a timely diagnosis and effective treatment.

How Screening Can Help

Lung cancer screening programmes in the UK use low-dose computed tomography (LDCT) scans to help find cancers at an early stage, often before symptoms develop, which can lead to simpler and more effective treatment15. This approach is particularly valuable for people at higher risk, such as those with COPD, offering the best chance of improving survival.

Role of CT Scans in COPD Detection

LDCT for lung cancer screening can also detect undiagnosed COPD, especially emphysema, in high-risk groups.

  • LDCT identifies structural lung changes consistent with COPD, even when spirometry is normal16,17.
  • Up to 20 per cent of individuals screened are found to have undiagnosed symptomatic COPD17.
  • Detection of emphysema and airflow obstruction on LDCT is linked to a substantially higher risk of lung cancer (over two-fold increase)18.
  • Early identification enables risk factor advice (smoking cessation), tailored management, and closer monitoring.

When Should You Get Screened?

Adults aged 55-74 who currently smoke or have smoked in the past are eligible for NHS lung cancer screening in the UK, especially if they have a history of COPD19,20.

NHS vs Private Screening

  • NHS: Free for those meeting criteria; initial risk assessment via GP, then an LDCT scan if high risk.
  • Private: Available at specialist clinical/hospitals across the UK.

Ezra Lung Cancer Screening

  • Ezra offers an additional Lungs CT Scan on top of its other scans for just £249. 
  • It is a 3-minute LDCT scan that can look for lung cancer, pulmonary nodules, emphysema, and more.

Lifestyle Changes to Reduce Lung Cancer Risk

Stop Smoking

  • Quitting smoking at any age lowers lung cancer risk quickly and continuously.
  • NHS Smokefree helpline (0300 123 1044) and local services offer free advice, medicines, and clinics. 
  • Smokers using NHS support are up to three times more likely to quit successfully compared to unassisted attempts; over half of quitters remain smoke-free after one month21.

Improve Lung Health

  • Regular exercise, 150+ minutes weekly, reduces lung cancer risk and helps manage symptoms22.
  • Pulmonary rehabilitation includes23:
    • Aerobic activity and strength exercises.
    • Breathing techniques like pursed-lip and deep diaphragmatic breathing to optimise lung function.
  • Maintain good air quality by ventilating homes, avoiding smoke/exposures, and using filters if needed.

Regular Monitoring and Health Check-Ups

  • Annual GP visits are recommended for COPD patients and those at risk; more frequent follow-up is needed if symptoms worsen24.
  • Routine tests include25,26:
    • Spirometry for lung function.
    • Imaging for higher-risk individuals or those with new/worsening symptoms.
  • Proactive monitoring enables early intervention and optimises long-term health.

Summary: How COPD Increases Lung Cancer Risk

People living with COPD face a significantly higher risk of developing lung cancer, even if they no longer smoke. Because both conditions share symptoms like persistent cough and breathlessness, new or worsening signs can be easily overlooked. Monitoring symptom changes, attending regular check-ups, and considering a low-dose CT scan for lung cancer screening can help detect problems early, when treatment is most effective. If you notice unusual symptoms, don’t wait, speak to your GP and take proactive steps to protect your lung health.

If you want to be proactive about your health, why not book an Ezra MRI Scan? You can add an Ezra Lung CT to screen for lung cancer, pulmonary nodules, emphysema, and more today.

Understand your risk for cancer with our 5 minute quiz.

Know Your Risk

Our scan is designed to detect potential cancer early.

Book Your Scan

References

1. Asthma + Lung UK. COPD survey 2022. Accessed November 14, 2025. https://www.asthmaandlung.org.uk/sites/default/files/2023-03/delayed-diagnosis-unequal-care-executive-summary.pdf 

2. Zhao G, Li X, Lei S, Zhao H, Zhang H, Li J. Prevalence of lung cancer in chronic obstructive pulmonary disease: A systematic review and meta-analysis. Front Oncol. 2022;12:947981. doi:10.3389/fonc.2022.947981 

3. Lung cancer statistics. Cancer Research UK. May 14, 2015. Accessed November 14, 2025. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/lung-cancer 

4. Chronic obstructive pulmonary disease (COPD). nhs.uk. October 20, 2017. Accessed November 14, 2025. https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/ 

5. Chronic obstructive pulmonary disease (COPD) - Causes. nhs.uk. October 3, 2018. Accessed November 14, 2025. https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/causes/ 

6. Agarwal AK, Raja A, Brown BD. Chronic Obstructive Pulmonary Disease. In: StatPearls. StatPearls Publishing; 2025. Accessed November 14, 2025. http://www.ncbi.nlm.nih.gov/books/NBK559281/ 

7. Qi Y, Yan Y, Tang D, et al. Inflammatory and Immune Mechanisms in COPD: Current Status and Therapeutic Prospects. J Inflamm Res. 2024;17:6603-6618. doi:10.2147/JIR.S478568 

8. Rivas M, Gupta G, Costanzo L, Ahmed H, Wyman AE, Geraghty P. Senescence: Pathogenic Driver in Chronic Obstructive Pulmonary Disease. Medicina (Kaunas). 2022;58(6):817. doi:10.3390/medicina58060817 

9. Qiao P, Sheng P, Liu H, Liang H. Chronic Obstructive Pulmonary Disease and Lung Cancer: A Meta-Analysis of Risk Association. Int J Chron Obstruct Pulmon Dis. 2025;20:3269-3277. doi:10.2147/COPD.S539213 

10. Czarnecka-Chrebelska KH, Mukherjee D, Maryanchik SV, Rudzinska-Radecka M. Biological and Genetic Mechanisms of COPD, Its Diagnosis, Treatment, and Relationship with Lung Cancer. Biomedicines. 2023;11(2):448. doi:10.3390/biomedicines11020448 

11. Barnes PJ. Oxidative Stress in Chronic Obstructive Pulmonary Disease. Antioxidants (Basel). 2022;11(5):965. doi:10.3390/antiox11050965 

12. Forder A, Zhuang R, Souza VGP, et al. Mechanisms Contributing to the Comorbidity of COPD and Lung Cancer. Int J Mol Sci. 2023;24(3):2859. doi:10.3390/ijms24032859 

13. Long-term lung conditions towards the end of life. Marie Curie. Accessed November 14, 2025. https://www.mariecurie.org.uk/professionals/palliative-care-knowledge-zone/lung-conditions 

14. Symptoms of lung cancer. Accessed November 10, 2025. https://www.cancerresearchuk.org/about-cancer/lung-cancer/symptoms 

15. Lung Cancer Screening | Cancer Research UK. Accessed November 14, 2025. https://www.cancerresearchuk.org/health-professional/cancer-screening/lung-cancer-screening 

16. Gonzalez J, Marín M, Sánchez-Salcedo P, Zulueta JJ. Lung cancer screening in patients with chronic obstructive pulmonary disease. Ann Transl Med. 2016;4(8):160. doi:10.21037/atm.2016.03.57 

17. Tisi S, Dickson JL, Horst C, et al. Detection of COPD in the SUMMIT Study lung cancer screening cohort using symptoms and spirometry. Eur Respir J. 2022;60(6):2200795. doi:10.1183/13993003.00795-2022 

18. Gould MK. Lung Cancer Screening in Individuals with Chronic Obstructive Pulmonary Disease. Finding the Sweet Spot. Am J Respir Crit Care Med. 2015;192(9):1027-1028. doi:10.1164/rccm.201508-1594ED 

19. Who is eligible for Lung Cancer Screening? :: South East London Cancer Alliance. Accessed November 14, 2025. https://www.sel-lunghealthcheck.nhs.uk/how-book/who-eligible-lung-health-check 

20. Lung Cancer Screening. RM Partners. Accessed November 14, 2025. https://rmpartners.nhs.uk/our-work/lung-cancer-screening/ 

21. Dobbie F, Hiscock R, Leonardi-Bee J, et al. Introduction. In: Evaluating Long-Term Outcomes of NHS Stop Smoking Services (ELONS): A Prospective Cohort Study. NIHR Journals Library; 2015. Accessed November 14, 2025. https://www.ncbi.nlm.nih.gov/books/NBK327138/ 

22. Lung cancer - Prevention. nhs.uk. October 3, 2018. Accessed November 14, 2025. https://www.nhs.uk/conditions/lung-cancer/prevention/ 

23. Pulmonary Rehabilitation after COVID-19 related illness. Accessed November 14, 2025. https://www.royalberkshire.nhs.uk/media/rirprct4/pulmonary-rehabilitation-exercises_mar23.pdf 

24. COPD_management. Accessed November 14, 2025. https://www.derbyshiremedicinesmanagement.nhs.uk/assets/Clinical_Guidelines/Formulary_by_BNF_chapter_prescribing_guidelines/BNF_chapter_3/COPD_management.pdf 

25. England NHS. NHS England » Enhancing GP direct access to diagnostic tests for patients with suspected chronic obstructive pulmonary disease, asthma, or heart failure. Accessed November 14, 2025. https://www.england.nhs.uk/long-read/enhancing-gp-direct-access-to-diagnostic-tests-for-patients-with-suspected-chronic-obstructive-pulmonary-disease-asthma-or-heart-failure/ 

26. Approved-copd-pathway-final-ammendments_v2. Accessed November 14, 2025. https://northyorkshireccg.nhs.uk/wp-content/uploads/2021/03/1-approved-copd-pathway-final-ammendments_v2.pdf