Qualitative emphysema and risk of COPD hospitalization in a multicenter CT lung cancer screening cohort study

Gazourian, Lee; Thedinger, William; Regis, Shawn M.; Pagura, Elizabeth; Price, Lori Lyn; Gawlik, Melissa; Ştefănescu, Cristina; Lamb, Carla; Rieger-Christ, Kimberly; Singh, Harpreet; Casasola, M; Walker, Alexander; Rupal, Arashdeep; Patel, Avignat S.; Come, Carolyn E.; Sanayei, Ava; Long, William P.; Rizzo, Giulia; McKee, Andrea B.; Washko, George R.; Estépar, Raúl San Jośe; Wald, Christoph; McKee, Brady; Thomson, Carey C.; Liesching, Timothy

doi:10.1016/j.rmed.2020.106245

Cited by 10 publications

(7 citation statements)

References 38 publications

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“…Baseline demographic and clinical variables, including age, sex, ethnicity, BMI, smoking history, were collected prospectively as part of the CTLS program and stored in a centralized data repository as previously described [ 21 , 22 ]. Additional clinical variables, including cancer, mortality, cause of death, date of pulmonary referral, reason for pulmonary referral, and ILD diagnosis, not already available in this data repository, were collected retrospectively by manual review of the electronic medical record or pulled directly from the EMR and stored utilizing a custom-designed database (FileMaker ProVersion 11; Filemaker Inc, Santa Clara, California).…”

Section: Methodsmentioning

confidence: 99%

Interstitial lung abnormalities in a large clinical lung cancer screening cohort: association with mortality and ILD diagnosis

et al. 2023

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Background Interstitial lung abnormalities (ILA) are CT findings suggestive of interstitial lung disease in individuals without a prior diagnosis or suspicion of ILD. Previous studies have demonstrated that ILA are associated with clinically significant outcomes including mortality. The aim of this study was to determine the prevalence of ILA in a large CT lung cancer screening program and the association with clinically significant outcomes including mortality, hospitalizations, cancer and ILD diagnosis. Methods This was a retrospective study of individuals enrolled in a CT lung cancer screening program from 2012 to 2014. Baseline and longitudinal CT scans were scored for ILA per Fleischner Society guidelines. The primary analyses examined the association between baseline ILA and mortality, all-cause hospitalization, and incidence of lung cancer. Kaplan–Meier plots were generated to visualize the associations between ILA and lung cancer and all-cause mortality. Cox regression proportional hazards models were used to test for this association in both univariate and multivariable models. Results 1699 subjects met inclusion criteria. 41 (2.4%) had ILA and 101 (5.9%) had indeterminate ILA on baseline CTs. ILD was diagnosed in 10 (24.4%) of 41 with ILA on baseline CT with a mean time from baseline CT to diagnosis of 4.47 ± 2.72 years. On multivariable modeling, the presence of ILA remained a significant predictor of death, HR 3.87 (2.07, 7.21; p < 0.001) when adjusted for age, sex, BMI, pack years and active smoking, but not of lung cancer and all-cause hospital admission. Approximately 50% with baseline ILA had progression on the longitudinal scan. Conclusions ILA identified on baseline lung cancer screening exams are associated with all-cause mortality. In addition, a significant proportion of patients with ILA are subsequently diagnosed with ILD and have CT progression on longitudinal scans. Trial registration number: ClinicalTrials.gov; No.: NCT04503044.

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Section: Methodsmentioning

confidence: 99%

Interstitial lung abnormalities in a large clinical lung cancer screening cohort: association with mortality and ILD diagnosis

et al. 2023

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“…The current U.S. national implementation of LCS uses thoracic CT to evaluate for lung cancer, but the acquired CT scan will be routinely evaluated for emphysema ( 28 ). Generally, the acquired LCS CT imaging data is analyzed for emphysema because of medical legal concerns with missing important diagnoses.…”

Section: Current State Of Copd Screeningmentioning

confidence: 99%

Emphysema Detection in the Course of Lung Cancer Screening: Optimizing a Rare Opportunity to Impact Population Health

Mulshine¹,

Aldigé

Ambrose

et al. 2023

Annals ATS

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“…The prevalence of emphysema detected by CT in lung screening cohorts was described in 22 papers (including cohort and case–control studies) [ 14 , 26–46 ]. The prevalence of emphysema detected in lung screening cohorts varied between 2.9% and 57% [ 36 , 46 ]. The wide variation in prevalence can be explained by differing inclusion criteria, CT scanning parameters, and methodology for assessing emphysema on CT (qualitative, semi-quantitative, quantitative).…”

Section: Pulmonary Findingsmentioning

confidence: 99%

“…The prevalence of emphysema detected during LDCT screening for lung cancer is dependent on inclusion criteria, but can be >50% [ 36 , 46 ].…”

Section: Pulmonary Findingsmentioning

confidence: 99%

ERS/ESTS/ESTRO/ESR/ESTI/EFOMP statement on management of incidental findings from low dose CT screening for lung cancer

O'Dowd,

Tietzova,

Bartlett

et al. 2023

European Journal of Cardio-Thoracic Surgery

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Background Screening for lung cancer with low radiation dose computed tomography has a strong evidence base, is being introduced in several European countries and is recommended as a new targeted cancer screening programme. The imperative now is to ensure that implementation follows an evidence-based process that will ensure clinical and cost effectiveness. This European Respiratory Society (ERS) task force was formed to provide an expert consensus for the management of incidental findings which can be adapted and followed during implementation. Methods A multi-European society collaborative group was convened. 23 topics were identified, primarily from an ERS statement on lung cancer screening, and a systematic review of the literature was conducted according to ERS standards. Initial review of abstracts was completed and full text was provided to members of the group for each topic. Sections were edited and the final document approved by all members and the ERS Science Council. Results Nine topics considered most important and frequent were reviewed as standalone topics (interstitial lung abnormalities, emphysema, bronchiectasis, consolidation, coronary calcification, aortic valve disease, mediastinal mass, mediastinal lymph nodes and thyroid abnormalities). Other topics considered of lower importance or infrequent were grouped into generic categories, suitable for general statements. Conclusions This European collaborative group has produced an incidental findings statement that can be followed during lung cancer screening. It will ensure that an evidence-based approach is used for reporting and managing incidental findings, which will mean that harms are minimised and any programme is as cost-effective as possible.

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Qualitative emphysema and risk of COPD hospitalization in a multicenter CT lung cancer screening cohort study

Cited by 10 publications

References 38 publications

Interstitial lung abnormalities in a large clinical lung cancer screening cohort: association with mortality and ILD diagnosis

Interstitial lung abnormalities in a large clinical lung cancer screening cohort: association with mortality and ILD diagnosis

Emphysema Detection in the Course of Lung Cancer Screening: Optimizing a Rare Opportunity to Impact Population Health

ERS/ESTS/ESTRO/ESR/ESTI/EFOMP statement on management of incidental findings from low dose CT screening for lung cancer

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