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Identifying Smoking-Related Disease on Lung Cancer Screening CT Scans: Increasing the Value
Elizabeth A Regan1,2, Katherine E Lowe1,2, Barry J Make1
1Division of Pulmonary Medicine National Jewish Health, Denver, Colorado.
Chronic Obstructive Pulmonary Diseases (Miami, Fla.)
|July 26, 2019
Summary
Lung cancer screening CT scans can identify comorbid diseases like cardiovascular disease, emphysema, and osteoporosis. This expanded analysis helps diagnose smoking-related conditions, potentially preventing adverse health events.
Area of Science:
- Pulmonary Medicine
- Radiology
- Cardiology
Background:
- Lung cancer screening (LCS) using chest computed tomography (CT) identifies early tumors but misses other smoking-related diseases.
- Most smokers die from comorbid conditions, not lung cancer.
- Assessing LCS scans for common comorbidities could enhance screening value.
Purpose of the Study:
- Determine the prevalence of coronary artery calcification (CAC), emphysema, and vertebral bone density in LCS-eligible scans.
- Quantify the association between these identified comorbidities and adverse health outcomes.
Main Methods:
- Analyzed CT scans from 4078 participants in the COPD Genetic Epidemiology study (COPDGene®) meeting LCS criteria.
- Assessed scans for CAC, emphysema, and vertebral bone density.
- Tracked adverse events including myocardial infarctions, strokes, pneumonia, respiratory exacerbations, and fractures.
Main Results:
- 77% of LCS-eligible scans showed at least one comorbidity: CAC (51%), emphysema (44%), osteoporosis (54%).
- 50% of participants experienced at least one adverse event.
- New diagnoses of cardiovascular disease, emphysema, and osteoporosis were made in 25%, 7%, and 46% of participants, respectively.
Conclusions:
- Expanded analysis of LCS CT scans reveals undiagnosed cardiovascular disease, emphysema, and osteoporosis.
- These findings correlate with increased adverse health events.
- LCS CT scans offer a valuable opportunity for early diagnosis and prevention of smoking-related diseases.
Keywords:
chronic obstructive pulmonary diseasecomorbiditiescopdlung cancer screeningssmoking-related diseaseMore Related Videos
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