BackgroundCOPD is a major cause of morbidity and mortality in populations eligible for lung cancer screening. We investigated the role of spirometry in a community-based lung cancer screening programme.MethodsEver smokers, age 55–74, resident in three deprived areas of Manchester were invited to a ‘Lung Health Check’ (LHC) based in convenient community locations. Spirometry was incorporated into the LHCs alongside lung cancer risk estimation (Prostate, Lung, Colorectal and Ovarian Study Risk Prediction Model, 2012 version (PLCOM2012)), symptom assessment and smoking cessation advice. Those at high risk of lung cancer (PLCOM2012 ≥1.51%) were eligible for annual low-dose CT screening over two screening rounds. Airflow obstruction was defined as FEV1/FVC<0.7. Primary care databases were searched for any prior diagnosis of COPD.Results99.4% (n=2525) of LHC attendees successfully performed spirometry; mean age was 64.1±5.5, 51% were women, 35% were current smokers. 37.4% (n=944) had airflow obstruction of which 49.7% (n=469) had no previous diagnosis of COPD. 53.3% of those without a prior diagnosis were symptomatic (n=250/469). After multivariate analysis, the detection of airflow obstruction without a prior COPD diagnosis was associated with male sex (adjOR 1.84, 95% CI 1.37 to 2.47; p<0.0001), younger age (p=0.015), lower smoking duration (p<0.0001), fewer cigarettes per day (p=0.035), higher FEV1/FVC ratio (<0.0001) and being asymptomatic (adjOR 4.19, 95% CI 2.95 to 5.95; p<0.0001). The likelihood of screen detected lung cancer was significantly greater in those with evidence of airflow obstruction who had a previous diagnosis of COPD (adjOR 2.80, 95% CI 1.60 to 8.42; p=0.002).ConclusionsIncorporating spirometry into a community-based targeted lung cancer screening programme is feasible and identifies a significant number of individuals with airflow obstruction who do not have a prior diagnosis of COPD.

This paper provides a conceptual argument for the sociological analysis of the everyday experiences of disabled people through the example of acquired brain injury (ABI) survivors. Most research concerning ABI has been carried out within a medical framework. This paper adds a new dimension to research concerning ABI, and indeed, to my knowledge, is the first to explore a long-term, interdisciplinary view of both ABI and neurological rehabilitation. This paper sets out how the use of critical sociological theory can provide thorough analyses of disabled people's experiences that are free from the prejudgement of traditional discourses.

This paper encourages researchers to consider their own identity to be of particular importance within any research project. Rather than seeing our own identities as being fully formed and therefore detached from a project, this paper suggests that we invest ourselves into research and acknowledge the impact we have on research. Investing ourselves into research, also involves considering our identities to be open to adaption. Consequently, an investigation of how our own identities can be influenced by the process of carrying out research is also discussed. It is suggested that this investment may open up endless possibilities for future research and practice. Notably, the process of self-investigation can result in transparent and ethical knowledge production. I use the example of my own research to highlight the advantages of remaining open to and embracing these opportunities for growth. Drawing on a poststructural conceptual framework, I critically explore some of the possibilities that a thorough interrogation of the self can create.

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