Introduction
Lung cancer (LC)-screening programs concern smokers at risk for cardiovascular diseases (CVDs) and chronic obstructive pulmonary disease (COPD). The LUMASCAN study aimed to evaluate the acceptability and feasibility of screening for these 3 diseases in a community population with centralized organization and to determine low-dose computed tomography (LDCT) markers associated with each disease.
Methods
This cohort enrolled subjects meeting NCCN criteria (v1.2014) in an organized LC-screening program including LDCT-scans, spirometry, evaluations of coronary artery calcifications (CACs), and a smoking-cessation plan at inclusion, 1 and 2-year, then telephone follow-up. Outcomes were the participation rate and the proportion of participants affected by LC, obstructive lung disease (OLD) or CVD events. Logistic-regression models were used to identify radiological factors associated with each disease.
Results
Between 2016 and 2019, 302 subjects were enrolled: 61% men, median age 58.8 years, 77% active smoker, 11% diabetes, 38% hypertension, 27% taking lipid-lowering agents. Inclusion, 1-year and 2-year participation rate were 99%, 81%, 79%, respectively. After a median follow-up of 5.81 years, screenings detected 12 (4%) LCs, 9/12 via LDCT (78% localized) and 3/12 during follow-up (all stage IV), 83 (27%) unknown OLD, and 131 (43.4%) moderate/severe CACs warranting a cardiology consultation. Preexisting COPD and moderate/severe CACs were associated with major CVD events with odds ratios of 1.98 [95% confident interval (CI) 1.00-3.88] and 3.27 [95% CI 1.72-6.43] respectively.
Conclusion
The LUMASCAN study demonstrated the feasibility of combined screening for LC, COPD and CVD in a community population. Its centralized organization enabled high participation and coordination of care providers.