Lung cancer survival and comorbidities in lung cancer screening participants of the Gdańsk screening cohort

Abstract

Background In 2010, the World Health Organisation recommended implementation of screening programmes in four groups of diseases—neoplasms, cardiovascular diseases (CVD), diabetes mellitus (DM) and chronic obstructive pulmonary disease (COPD). It is due to the fact that they share the same, modifiable risk factors. Methods Between 2009 and 2011, 8637 heavy smokers (aged 50–75, smoking history >20 pack-years) were screened in the Pomeranian Pilot Lung Cancer Screening Programme (PPP) in Gdańsk, Poland. We looked at 5-year follow-up and analysed the medical events and comorbidities of all participants. One health care provider in the Polish health care system provides a unique opportunity to gather most reliable data on all medical events in each person. Results In 52.0% of lung cancer screening participants CVD (33.5%), DM (26.0%) and COPD (21.0%) were diagnosed. Prevalence of these diseases is higher in lung cancer patients than in the non-cancer screening group (P < 0.0001). One hundred and seven (1.2%) lung cancers were diagnosed during PPP programme performance and another 382 cases (4.4%) in the 5-year follow-up, so the potential mean annual lung cancer detection rate is 0.77%. Conclusions Lung cancer screening programme offers a great potential for joint screening of lung cancer, CVD, diabetes and COPD.

Analysis of lung cancer risk model (PLCOM2012 and LLPv2) performance in a community-based lung cancer screening programme

“…Including these in a screening programme may improve cost-effectiveness, although quantifying such an improvement will require measurement of these potential added benefits. 36 …”

“…Including these in a screening programme may improve cost-effectiveness, although quantifying such an improvement will require measurement of these potential added benefits. 36 We investigated a number of objective measures of 'smoking damage' (FEV 1 /FVC ratio, CAC and presence of emphysema on CT), not included in the PLCO M2012 model, to see if they were independently predictive of lung cancer after controlling for PLCO risk score. The presence and degree of CAC remained an independent predictor of lung cancer.…”

Evaluation of Conventional Cardiovascular Risk Factors and Ordinal Coronary Artery Calcium Scoring in a Lung Cancer Screening Cohort

“…Furthermore, the high CVC prevalence in this group suggests the possibility of using CAC to personalize cardiovascular risk more precisely. Data on comorbidity in LCS cohorts vary by country and population screened [25]. However, according to our results, they indicate a high cardiovascular risk [26,27] and increased mortality due to cardiovascular diseases [28].…”

Chronic Obstructive Pulmonary Disease and Lung Cancer: A Review for Clinicians

“…In 8637 heavy smokers screened in the Pomeranian Pilot Lung Cancer Screening Program, 52% had cardiovascular disease (33 %), diabetes (26%), and COPD (21%). 141 A study that performed a "lung health check" during a lung cancer screening reported COPD in 57% of patients; 67% did not have a prior diagnosis. 142 Studies that incorporate spirometry into screening have similarly reported high incidences of previously undiagnosed COPD.…”