The additional value of lung cancer screening program in identifying unrecognized diseases

Area of Science:

• Radiology
• Pulmonology
• Oncology

Background:

• Low-dose CT (LDCT) screening for lung cancer can identify other undiagnosed diseases.
• This improves program efficacy and cost-effectiveness.
• The study evaluated LDCT findings beyond nodules for associations with non-oncologic and oncologic diseases.

Purpose of the Study:

• To assess the association between abnormal findings on LDCT scans and subsequent cardiovascular (CD), respiratory (RD), and oncologic (OD) diseases.
• To explore the broader diagnostic potential of LDCT scans in lung cancer screening programs.

Main Methods:

• LDCT scans from the "Un Respiro per la vita" lung cancer screening program were analyzed.
• Abnormal findings, excluding lung nodules, were recorded.
• Participants' acute care admissions for CD, RD, and OD within three years were tracked.
• Univariable and multivariable logistic regression models assessed associations.

Main Results:

• Of 746 participants, 11 (1.5%) were diagnosed with lung cancer.
• 16.1% were admitted for acute care: 8.6% for CD, 4.3% for RD, 5.2% for OD.
• Valve calcification (OR 2.02) and mucus plugs (OR 3.37) associated with CD.
• Sub-pleural fibrosis showed a protective role (OR 0.47).
• Lung nodules >8mm (OR 5.54), tracheal deviation (OR 6.04), and mucus plugs (OR 4.00) associated with OD.
• Centrilobular emphysema showed a trend for association with RD (OR 1.97).

Conclusions:

• LDCT scan findings are associated with subsequent cardiovascular, respiratory, and oncologic diseases.
• The diagnostic information from LDCT extends beyond lung cancer screening.
• LDCT has potential for early detection of multiple disease types.