Lung cancer screening provides an opportunity for early diagnosis and treatment of interstitial lung disease

Abstract

Interstitial lung abnormalities (ILA) can be incidentally detected in patients undergoing low-dose CT screening for lung cancer. In this retrospective study, we explore the downstream impact of ILA detection on interstitial lung disease (ILD) diagnosis and treatment. Using a targeted approach in a lung cancer screening programme, the rate of de novo ILD diagnosis was 1.5%. The extent of abnormality on CT and severity of lung function impairment, but not symptoms were the most important factors in differentiating ILA from ILD. Disease modifying therapies were commenced in 39% of ILD cases, the majority being antifibrotic therapy for idiopathic pulmonary fibrosis.

The detection, assessment and clinical evolution of interstitial lung abnormalities identified through lung cancer screening

“…We found an ILA prevalence rate of 3.9%, of which 40.7% were subsequently diagnosed with ILD within 5 years. This was equivalent to 1.6% of the total population screened, supporting recent findings from another UK screening study [ 12 ]. We observed a mortality rate of ∼25% at 5 years.…”

“…Identifying which cases of ILA will evolve into clinically significant ILD is of key importance, given the increased utility of lung cancer screening programmes. A recent report from a United Kingdom (UK) screening population identified that 65% of patients with ILA were diagnosed with ILD on initial clinical assessment [ 12 ]. However, there is a lack of longitudinal data describing the evolution of ILA to ILD, with associated risk factors, within the context of lung cancer screening.…”

Contemporary Concise Review 2022: Interstitial lung disease

“…In a retrospective study of patients undergoing lung‐cancer screening 1.51% of subjects were diagnosed with ILD and treatment was commenced in eligible patients 32 . Targeted screening programmes for high‐risk individuals may result in improved outcomes.…”

“…In a retrospective study of patients undergoing lung-cancer screening 1.51% of subjects were diagnosed with ILD and treatment was commenced in eligible patients. 32 Targeted screening programmes for high-risk individuals may result in improved outcomes. Such patients could be identified by calculating the pre-test probability of IPF using a framework compiled by an international working group of ILD specialists, although these risk factors have been designed to be interpreted alongside CT findings.…”

Risk Stratifying Interstitial Lung Abnormalities to Guide Early Diagnosis of Interstitial Lung Diseases

“…Delayed diagnosis is common in interstitial lung diseases (ILDs) and is associated with decreased quality of life and a poor prognosis (1). Early diagnosis and initiation of appropriate management could improve patient outcomes (2)(3)(4)(5). Studies in idiopathic pulmonary fibrosis (IPF) demonstrated that antifibrotic therapies also slow down disease progression in patients with more preserved lung function (3,5).…”