Improving Selection Criteria for Lung Cancer Screening. The Potential Role of Emphysema

Sánchez-Salcedo, Pablo; Wilson, David O.; de-Torres, Juan P.; Weissfeld, Joel L.; Bertó, Juan; Campo, Arantza; Alcaide, Ana B.; Pueyo, Jesús C.; Bastarrika, Gorka; Seijó, Luis; Pajares, María J.; Pı́o, Rubén; Montuenga, Luis M.; Zulueta, Javier

doi:10.1164/rccm.201410-1848oc

Cited by 98 publications

(75 citation statements)

References 36 publications

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“…The authors concluded that the results obtained in the LC screening program were comparable to observations that had been previously reported in other European programs, and that LDCT was a valid and feasible diagnostic tool in this context (3). In another study, the same investigators (4) showed that LC screening programs that are exclusively based on the National Lung Screening Trial (NLST) criteria may fail to identify all the cases of LC. On this basis, the investigators suggested that the application of the NLST criteria in patients with emphysema enhanced the detection rates of LC, while lowered the number of missed cases (4).…”

Section: Evidence and Epidemicssupporting

confidence: 63%

“…In this regard, low-dose computerized tomography (LDCT) has been proposed as a useful screening tool for LC (85). In keeping with, several authors (3,4,86,87) have demonstrated the benefits of LDCT in the early diagnosis of LC among smokers. Nonetheless, other authors have claimed that in LC screening programs, LDCT should not be still widely applied in the general population up until more convincing results are published (2).…”

Section: Evidence and Epidemicsmentioning

confidence: 99%

“…Importantly, COPD and chronic airway obstruction have long been associated with LC development (2)(3)(4)(5)(10)(11)(12)(13)16,79). Interestingly, the prevalence of LC has been consistently greater in men than in females.…”

Section: Evidence and Epidemicsmentioning

confidence: 99%

“…Importantly, in patients with moderate-to-severe COPD, the prevalence of LC can go up as high as five-fold that of smokers without the disease (18)(19)(20)(21)(22)(23)(24). Furthermore, the epidemiologic relevance of emphysema in the development of LC in patients with COPD has also been highlighted (2)(3)(4)(5)16). The need for well-validated and practical LC screening tools to be implemented in clinical settings has also been underscored in several recent studies (2)(3)(4)(5)17).…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, the epidemiologic relevance of emphysema in the development of LC in patients with COPD has also been highlighted (2)(3)(4)(5)16). The need for well-validated and practical LC screening tools to be implemented in clinical settings has also been underscored in several recent studies (2)(3)(4)(5)17).…”

Section: Introductionmentioning

confidence: 99%

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Relationships between chronic obstructive pulmonary disease and lung cancer: biological insights

Barreiro¹,

Bustamante

Curull³

et al. 2016

J. Thorac. Dis.

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Lung cancer (LC) has become one of the leading causes of preventable death in the last few decades. Cigarette smoking (CS) stays as the main etiologic factor of LC despite that many other causes such as occupational exposures, air pollution, asbestos, or radiation have also been implicated. Patients with chronic obstructive pulmonary disease (COPD), which also represents a major cause of morbidity and mortality in developed countries, exhibit a significantly greater risk of LC. The study of the underlying biological mechanisms that may predispose patients with chronic respiratory diseases to a higher incidence of LC has also gained much attention in the last few years. The present review has been divided into three major sections in which different aspects have been addressed: (I) relevant etiologic agents of LC; (II) studies confirming the hypothesis that COPD patients are exposed to a greater risk of developing LC; and (III) evidence on the most relevant underlying biological mechanisms that support the links between COPD and LC. Several carcinogenic agents have been described in the last decades but CS remains to be the leading etiologic agent in most geographical regions in which the incidence of LC is very high. Growing evidence has put the line forward the implications of COPD and especially of emphysema in LC development. Hence, COPD represents a major risk factor of LC in patients. Different avenues of research have demonstrated the presence of relevant biological mechanisms that may predispose COPD patients to develop LC. Importantly, the so far identified biological mechanisms offer targets for the design of specific therapeutic strategies that will further the current treatment options for patients with LC. Prospective screening studies, in which patients with COPD should be followed up for several years will help identify biomarkers that may predict the risk of LC among these patients.

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Section: Evidence and Epidemicssupporting

confidence: 63%