Five-Year Outcome of Lung Cancer Detection in Patients With and Without Airflow Obstruction in a Primary Care Outpatient Practice

Bechtel, Joel J.; Kelley, William A.; Coons, Teresa; Mohler, Philip; Mohler, Andrew; James, David A.; Petty, Thomas L.

doi:10.1097/jto.0b013e3181b6be12

Cited by 5 publications

(4 citation statements)

References 13 publications

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“…BECHTEL et al [114] investigated the efficacy of early detection of lung cancer by chest computed tomography for patients with COPD, and reported that six lung cancer cases were detected among 88 high-risk patients with COPD (6.8%). There were three stage I patients, and three out of six survived for .5 yrs.…”

Section: Importance Of Lung Cancer Screening In Copd Patientsmentioning

confidence: 99%

Early detection of COPD is important for lung cancer surveillance

Sekine¹,

Katsura²,

Koh³

et al. 2011

Eur Respir J

123

101

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It is well known that chronic obstructive pulmonary disease (COPD) is a significant risk factor for lung cancer. Approximately 1% of COPD patients develop lung cancer every year, which may be associated with genetic susceptibility to cigarette smoke. Chronic inflammation caused by toxic gases can induce COPD and lung cancer. Inflammatory mediators may promote the growth of bronchioalveolar stem cells, and activation of nuclear factor-kB and signal transducer and activator of transcription 3 play crucial roles in the development of lung cancer from COPD.Low-dose computed tomography (LDCT) is an effective procedure for the early detection of lung cancer in high-risk patients. However, determining which patients should be screened for lung cancer in a primary care setting is difficult. In this article, we review the epidemiology and aetiology of lung cancer associated with COPD, verify the efficacy of lung cancer screening by LDCT, and discuss the importance of early detection of COPD for lung cancer surveillance.We propose that, for the prevention of both diseases, COPD screening in smokers should be initiated as early as possible, so they can stop smoking and so that candidates for an efficient lung cancer screening programme can be identified.

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Section: Importance Of Lung Cancer Screening In Copd Patientsmentioning

confidence: 99%

Early detection of COPD is important for lung cancer surveillance

Sekine¹,

Katsura²,

Koh³

et al. 2011

Eur Respir J

123

101

View full text Add to dashboard Cite

show abstract

“…If upcoming results of randomized controlled trials show a benefit of lung screening, this tool could be of help to select patients for screening. 10 In 13 of the 58 patients in whom it was obtained, HRCT chest detected lesions in the lung; 11 of these 13 patients had lung malignancy. One of the 12 patients with lung cancer in our study had normal HRCT chest; the cancer in this patient was revealed by bronchoscopy.…”

Section: Discussionmentioning

confidence: 99%

Screening COPD (Chronic Obstructive Pulmonary Disease) Patients for lung Cancer

Ahmad¹,

Bhat²,

Parveen³

et al. 2016

IJMRP

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Introduction:Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for both the development of primary lung cancer, as well as poor outcome after lung cancer diagnosis and treatment. The present study was undertaken to screen COPD patients for lung cancer and to find clinical and laboratory correlates of lung cancer in patients of COPD. Material and Methods: The present hospital based study comprised of 200 consecutive patients suffering with COPD. The patients were subjected to chest -radiography (both posteroanterior and lateral views), sputum cytology, fibre optic bronchoscopy and high resolution computed tomography (HRCT). Data was analyzed by standard statistical procedure using descriptive statistics method and comparisons were made by using chi-square test, and odds ratio. A 'p' value of < 0.05 was taken as statistically significant. Results: Among the various screening modalities used in this study, sputum cytology provided the lowest sensitivity (33.33%) and specificity (67.67%) while HRCT chest afforded the best sensitivity (91.7%) and specificity (95.7%). The variables significantly associated with lung cancer in our study were smoking, anorexia, anemia, weight loss, clubbing, and indices of lung function tests. Conclusion:In conclusion, patients with COPD constitute a group at high risk for lung cancer. Screening these patients, particularly those with increasing severity of obstruction is worthwhile in as much as it has the promise of early detection and consequently early treatment and improved survival. Chest CT appears to be the best screening procedure given its excellent sensitivity and specificity.

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“…In the current cohort the prevalence of COPD was 79.6% (95% confidence interval: 75.9%-83.3%). Bechtel et al used a questionnaire to prospectively study over a 5 year period, 430 high risk patients in communitybased primary care, with 126 showing airway obstruction developing lung cancer in 8, but 10 patients without airway obstruction also developed lung cancer [15,16]. Turner and colleagues found an association between self-reported physician-diagnosed chronic bronchitis and emphysema and lung cancer mortality in a prospective study of 448,600 lifelong nonsmokers, yielding 1,759 lung cancer deaths over a 20 year follow up [17].…”

Section: Discussionmentioning

confidence: 99%

Chronic obstructive pulmonary disease with lung cancer: Prevalence, severity, and common pathogenesis

Jp¹,

Ea²,

Mk³

et al. 2016

J Cancer Res Ther.

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Objectives: To develop a clinical prediction model of contribution of chronic obstructive pulmonary disease (COPD) to the pathogenesis of lung cancer, by reporting the estimated prevalence and severity by GOLD criteria in a single-institution cohort of patients with newly diagnosed lung cancer. Primary objective was investigating the effects of impaired lung function with various histological cell types on crude survival, while considering the initial staging of disease extent. Materials & methods: A total of 441 patients, in this historical cohort from electronic medical records, completed spirometry prior to invasive diagnostic procedures and initial treatment of their lung cancer. All statistical analyses, including ANOVA and survival analysis, were performed using SAS version 9.1 software. Results: Estimated prevalence of COPD was 79.1% (95% confidence interval: 71.3%-82.9%). Lung function as measured by spirometry was a significant predictor of survival time in months (p.0001) both with and without adjusting for tumor-cell-type, age, and stage of disease. Median survival was similar (p0.32) and longer among those patients with normal pulmonary function, those with restrictive disease patterns, and those with COPD-GOLD-1 defects. Median survival was shortest among patients with COPD-GOLD-4 impairment (p0.001). Those patients with COPD-GOLD-2 and COPD-GOLD-3 impairment levels had intermediate survival times (p0.003). Conclusions: This investigation suggests that strategies for early detection and slowing the progression of COPD before the development of lung cancer might increase patient survival. As demonstrated in this study, the presence and severity of COPD in lung cancer patients is an independent predictor of survival time, different from the established staging of initial extent of disease.

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Five-Year Outcome of Lung Cancer Detection in Patients With and Without Airflow Obstruction in a Primary Care Outpatient Practice

Abstract: A questionnaire, self-administered in a primary care office setting, helps identify patients at high risk of lung cancer. If upcoming results of randomized controlled trials show a benefit of lung screening, this tool could be of help to select patients for screening.

Cited by 5 publications

References 13 publications

Early detection of COPD is important for lung cancer surveillance

Early detection of COPD is important for lung cancer surveillance

Screening COPD (Chronic Obstructive Pulmonary Disease) Patients for lung Cancer

Chronic obstructive pulmonary disease with lung cancer: Prevalence, severity, and common pathogenesis

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