1. The importance of low-dose CT screening to identify emphysema in asymptomatic participants with and without a prior diagnosis of COPD
- Author
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David Steiger, M. Faisal Siddiqi, Rowena Yip, David F. Yankelevitz, Claudia I. Henschke, Artit Jirapatnakul, Raja Flores, Andrea Wolf, Daniel M. Libby, James P. Smith, Mark Pasmantier, A.P. Reeves, Steven Markowitz, Albert Miller, Jose Cervera Deval, Heidi Roberts, Demetris Patsios, Shusuke Sone, Takaomi Hanaoka, Javier Zulueta, Juan P. de-Torres, Maria D. Lozano, Ralph Aye, Kristin Manning, Thomas Bauer, Stefano Canitano, Salvatore Giunta, Enser Cole, Karl Klingler, John H.M. Austin, Gregory D.N. Pearson, Dorith Shaham, Cheryl Aylesworth, Patrick Meyers, Shahriyour Andaz, Davood Vafai, David Naidich, Georgeann McGuinness, Barry Sheppard, Matthew Rifkin, M. Kristin Thorsen, Richard Hansen, Samuel Kopel, William Mayfield, Dan Luedke, Donald Klippenstein, Alan Litwin, Peter A. Loud, Leslie J. Kohman, Ernest M. Scalzetti, Richard Thurer, Nestor Villamizar, Arfa Khan, Rakesh Shah, Xueguo Liu, Gary Herzog, Diana Yeh, Ning Wu, Joseph Lowry, Mary Salvatore, Carmine Frumiento, David S. Mendelson, Michael V. Smith, Robert Korst, Jana Taylor, Michelle S. Ginsberg, Michaela Straznicka, Mark Widmann, Gary Cecchi, Terence A.S. Matalon, Paul Scheinberg, Shari-Lynn Odzer, David Olsen, Fred Grannis, Arnold Rotter, Daniel Ray, David Mullen, Peter H. Wiernik, Edson H. Cheung, Melissa Lim, Louis DeCunzo, Robert Glassberg, Harvey Pass, Carmen Endress, Mark Yoder, Palmi Shah, Laura Welch, Michael Kalafer, Jeremy Green, James Walsh, David Bertsch, Elmer Camacho, Cynthia Chin, James O'Brien, and James C. Willey
- Subjects
Male ,Chronic bronchitis ,medicine.medical_specialty ,medicine.medical_treatment ,Prior diagnosis ,Asymptomatic ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Internal medicine ,medicine ,Low dose ct ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Lung cancer ,Prospective cohort study ,Emphysema ,COPD ,business.industry ,Infant, Newborn ,respiratory system ,medicine.disease ,respiratory tract diseases ,Pulmonary Emphysema ,030220 oncology & carcinogenesis ,Smoking cessation ,medicine.symptom ,business ,Tomography, X-Ray Computed - Abstract
Purpose Chronic Obstructive Pulmonary Disease (COPD) includes chronic bronchitis, small airways disease, and emphysema. Diagnosis of COPD requires spirometric evidence and may be normal even when small airways disease or emphysema is present. Emphysema increases the risk of exacerbations, and is associated with all-cause mortality and increased risk of lung cancer. We evaluated the prevalence of emphysema in participants with and without a prior history of COPD. Methods We reviewed a prospective cohort of 52,726 subjects who underwent baseline low dose CT screening for lung cancer from 2003 to 2016 in the International Early Lung Cancer Action Program. Results Of 52,726 participants, 23.8%(12,542) had CT evidence of emphysema. Of these 12,542 participants with emphysema, 76.5%(9595/12,542) had no prior COPD diagnosis even though 23.6% (2258/9595) had moderate or severe emphysema. Among 12,542 participants, significant predictors of no prior COPD diagnosis were: male (OR = 1.47, p Conclusion Emphysema was identified in 23.8% participants undergoing LDCT and was unsuspected in 76.5%. LDCT provides an opportunity to identify emphysema, and recommend smoking cessation.
- Published
- 2020