ObjectivesLung cancer screening using low-dose CT may be not effective without considering the presence of comorbidities related to chronic smoking. The aim of the study was to establish the prevalence of chronic obstructive pulmonary disease (COPD) in group of phighlight the potential benefits atients participating in the largest Polish lung cancer screening programme MOLTEST-BIS and attempt to confirm the necessity of combined lung cancer and COPD screening.DesignCohort, prospective study.SettingMedical University of Gdańsk, PolandParticipantsThe study included 754 participants in lung cancer screening trial from the Pomeranian region, aged 50–70 years old, current and former smokers with a smoking history ≥30 pack-years.Primary and secondary outcome measuresQuestionnaire, physical examination, anthropometric measurements, spirometry test before and after inhaled bronchodilator (400 µg of salbutamol)ResultsObstructive disorders were diagnosed in 186 cases (103 male and 83 female). In the case of 144 participants (19.73%), COPD was diagnosed. Only 13.3% of participants with COPD were known about the disease earlier. According to classification of airflow limitation 55.6% of diagnosed COPD were in Global Initiative for Chronic Obstructive Lung Disease (GOLD) 1 (mild), 38.9% in GOLD 2 (moderate), 4.9% in GOLD 3 (severe) and 0.7% in GOLD 4 (very severe) stage. Women with recognition of COPD were younger than men (63.7 vs 66.3 age) and they smoked less cigarettes (41.1 vs 51.9 pack-years).ConclusionsPrevalence of COPD in Polish lung cancer screening cohort is significant. The COPD in this group is remarkably under-diagnosed. Most diagnosed COPD cases were in the initial stage of advancement. This early detection of airflow limitation highlights the potential benefits arising from combined oncological-pulmonary screening.NKBBN

Objectives: Dyspnea is one of the most predominant symptom in clinical practice. There is a lack of data about incidents of dyspnea among Polish adults therefore it would be important to establish prevalence of this symptom before COVID-19 pandemic to assess the impact of this infection on the functioning of the adult Polish population in the future. The aim of the study was to establish prevalence of dyspnea in adult Polish population. Material and Methods: It was an observational-cross-sectional study, with representative sample of adult Poles aged 18-79 years. The 2413 participants were surveyed. Responders were asked if and when dyspnea occurs and what is its severity in relation to one of four categories (A, B, C, and D) describing the impact of dyspnea on reduced exercise tolerance and daily activities. Results: The 67.1% of the respondents answered negatively to all question about experiencing dyspnea (females (F) 61% vs. males (M) 74%, p < 0.05). Dyspnea only during intense physical exertion (A), was reported by 22.8% (F 26.2% vs. M 19.2%, p = 0.07). Dyspnea limiting daily activities (B, C and D) was reported by 10.1% (F 13.1% vs. M 7%, p < 0.05). Significant differences in the severity of dyspnea were found between the age groups. People diagnosed with chronic heart failure or lung diseases significantly more often reported dyspnea than people without these conditions. Conclusions: Every tenth Pole reported dyspnea limiting performing activities of daily living. Additionally, about 20% of Poles experienced dyspnea considered as "gray area", only during intense physical exertion, that requires deepening and clarifying the medical history.

Background Lung cancer and cardiovascular disease (CVD) are leading worldwide mortality causes firmly related to smoking. Lung cancer screening (LCS) consisted in performing low-dose computed tomography (LDCT) offers an opportunity for simultaneous coronary artery calcification (CAC) assessment. Purpose The study aimed to determine the usefulness of the visual assessment of CAC in the prediction of all-cause death and non-fatal cardiovascular outcomes including myocardial infarction and stroke. Methods The study involved 6580 participants aged 50–79 years, current or former smokers with a cigarette smoking history of at least 30 pack-years, who were qualified for lung cancer screening program performed between April 2016 and May 2018. CAC was visually scored on ungated LDCT scans in the range of 0–12 based on the length of calcification involvement in four main coronary arteries. CAC severity was categorized into groups of 0, 1–3, 4–12. The primary outcome was all-cause mortality. The secondary outcome was major adverse cardiovascular events (composite of CVD death, nonfatal myocardiaI infarction, nonfatal stroke). The outcomes data were obtained by using the National Health Care Provider Registry of death and hospitalizations. The mean time of follow-up was 41.1 months (SD 8.3). Logistic regression analysis was used to determine the risk of mortality according to the CAC category adjusted for age, pack-years of cigarette smoking, and sex. Results The rate of all-cause death substantially increased in groups of higher CAC and it was consecutively 2.7% (89 of 3288 subjects) for a score of 0, 4.2% (66 of 1582 subjects) for a score of 1–3 and 8.3% (145 of 1742 subjects) for a score of 4–12. With the use of subjects with a CAC score of 0 as the reference group, adjusted for sex, age, and pack-years of smoking, a CAC score of at least 4 was a significant predictor of all-cause death (hazard ratio [HR], 1.89; 95% CI: 1.42; 2.52; P&lt;0.05). Similar results were observed for the composite of CVD death, nonfatal myocardial infarction, nonfatal stroke with even greater significance. The rate of secondary outcames was 1.6% (51/3276) in a 0 score cohort, 3.0% (47/1570) in a 1–3 score cohort and 7.5% (130/1732) in a 4–12 score cohort. Both CAC score in the range 1–3 ([HR], 1.57; 95% CI: 1.05; 1.2.35; P&lt;0.05), and 4–12 ([HR], 3.55; 95% CI: 2.50; 5.04; P&lt;0.05) were a significant predictors of major adverse cardiovascular event incidence. Conclusions Visual assessment of CAC provides solid evidence of all-cause death and cardiovascular incidents independently of traditional coronary risk factors. Therefore evaluation of CAC in LDCT scans offers a unique opportunity for instituting CVD risk assessment in lung cancer screening program. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Centre for Research and Development of Poland.

Background: To improve the effectiveness of lung cancer screening using low-dose computed tomography (LDCT), the presence of smoking-related comorbidities that may significantly affect mortality in this group should be taken into account. Material and methods: A questionnaire survey and spirometry tests were conducted in a group of 730 respondents as part of a lung cancer screening study between 2016 and 2018. People diagnosed with COPD underwent a three-year follow-up to assess the incidence of medical events. Results: Our study confirmed that cardiovascular diseases (CVDs) were the most common comorbidities in patients who were diagnosed with COPD and participated in LDCT lung cancer screening. Among the CVDs, the most common were arterial hypertension (45.8%) and coronary artery disease (12.5%). Tobacco-related diseases (e.g. CVD, lung cancer, and exacerbations of COPD) were the leading causes of emergency department visits and hospitalizations. The number of visits due to COPD in specialized clinics more than doubled in the observed period. Conclusions: Properly planned screening tests allow not only for the detection of the disease for which they were designed but also for the assessment of comorbidities. In patients undergoing lung cancer screening, it is justified to extend the diagnostics to include spirometry.

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