Interstitial lung abnormalities are associated with increased mortality in smokers

Hoyer, Nils; Wille, Mathilde Marie Winkler; Thomsen, Laura H.; Wilcke, Torgny; Dirksen, Asger; Pedersen, Jesper Holst; Saghir, Zaigham; Ashraf, Haseem; Shaker, Saher Burhan

doi:10.1016/j.rmed.2018.02.001

Cited by 60 publications

(52 citation statements)

References 17 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Lung cancer CT screening studies report ILA prevalence of 4.0–16.7% . A Japanese screening cohort that included 48% never smokers reported a rate of 2.6% .…”

Section: Introductionmentioning

confidence: 99%

“…Although the significance of ILA is not clearly defined, studies have found associated decrements in exercise capacity, reduced health and functional status, decline in lung function and increased risk of all-cause mortality and pulmonary fibrosis specific mortality. [4][5][6][7][8][9] Detection of ILA in populations receiving CT scans for other reasons may provide much needed insights into the natural history of fibrotic lung disease and inform the discussion about indications for treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Lung cancer CT screening studies report ILA prevalence of 4.0-16.7%. 1,8,[10][11][12] A Japanese screening cohort that included 48% never smokers reported a rate of 2.6%. 13 Non-lung cancer screening cohorts have estimated ILA prevalence of 7-9%.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Interstitial lung abnormalities in the Queensland Lung Cancer Screening Study: prevalence and progression over 2 years of surveillance

Mackintosh

Marshall

Slaughter

et al. 2019

Internal Medicine Journal

View full text Add to dashboard Cite

Background We report the prevalence and progression of incidentally detected interstitial lung abnormalities (ILA) in the Queensland Lung Cancer Screening Study cohort. Methods About 256 volunteers aged 60–74, with ≥30 pack years smoking history and forced expiratory volume in 1 s (FEV1) ≥50% predicted underwent low‐dose computed tomography (CT) chest screening. Electronic search of baseline (T0) and 2‐year follow‐up (T2) CT reports identified candidate cases using Fleischner Society interstitial terminology. Candidate CT were reviewed in a randomised order by two experienced radiologists and a senior respiratory medicine trainee blinded to the existing reports. Scans were evaluated for the presence and extent of ILA using an in‐house score, and graded for progression. Results ILA were detected in 20/256 baseline cases (7.8%) with no incident cases detected at T2 surveillance imaging. Of these 20 cases, 9 (45%) had reticulation, 18 (90%) had ground glass change, 1 had traction bronchiectasis and 1 had randomly distributed nodularity. Seven cases with ground glass changes also had areas of reticulation, and only two had reticulation alone. All ILA were graded as minor except for traction bronchiectasis, which was moderate. Only one case progressed on T2 imaging. ILA were associated with the presence of auscultatory crackles (50% vs 11.6%, P = 0.001) and a lesser degree of emphysema (mean % volumetric emphysema 6.7% vs 9.8%, P = 0.009). No relationship was observed between baseline and serial lung function parameters. Conclusion ILA are frequent incidental findings in lung cancer screening. In the majority of cases these abnormalities do not appear to change significantly over a 2‐year period of surveillance.

show abstract

“…Lung cancer CT screening studies report ILA prevalence of 4.0–16.7% . A Japanese screening cohort that included 48% never smokers reported a rate of 2.6% .…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Interstitial lung abnormalities in the Queensland Lung Cancer Screening Study: prevalence and progression over 2 years of surveillance

Mackintosh

Marshall

Slaughter

et al. 2019

Internal Medicine Journal

View full text Add to dashboard Cite

show abstract

“…The ICD10codes used to define the specific diseases and disease groups are listed in Supplementary Table 1. We used Cox regression analysis to handle the censoring that was introduced by the known increased mortality of participants with ILA [13].…”

Section: Discussionmentioning

confidence: 99%

“…There are reports of a higher mortality from lung cancer and pulmonary fibrosis in patients with ILA [7,13]. However, the prevalence of ILA is much higher than the prevalence of ILDs as clinical entities and only a few of all people with ILA develop clinical disease [7,[13][14][15][16]. The role of ILA in the early detection of ILD remains to be established.…”

Section: Introductionmentioning

confidence: 99%

Increased respiratory morbidity in individuals with interstitial lung abnormalities

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background: Interstitial lung abnormalities (ILA) are common in participants of lung cancer screening trials and broad population-based cohorts. They are associated with increased mortality, but less is known about disease specific morbidity and healthcare utilisation in individuals with ILA. Methods: We included all participants from the screening arm of the Danish Lung Cancer Screening Trial with available baseline CT scan data (n = 1990) in this cohort study. The baseline scan was scored for the presence of ILA and patients were followed for up to 12 years. Data about all hospital admissions, primary healthcare visits and medicine prescriptions were collected from the Danish National Health Registries and used to determine the participants' disease specific morbidity and healthcare utilisation using Cox proportional hazards models. Results: The 332 (16.7%) participants with ILA were more likely to be diagnosed with one of several respiratory diseases, including interstitial lung disease (HR: 4.9, 95% CI: 1.8-13.3, p = 0.008), COPD (HR: 1.7, 95% CI: 1.2-2.3, p = 0.01), pneumonia (HR: 2.0, 95% CI: 1.4-2.7, p < 0.001), lung cancer (HR: 2.7, 95% CI: 1.8-4.0, p < 0.001) and respiratory failure (HR: 1.8, 95% CI: 1.1-3.0, p = 0.03) compared with participants without ILA. These findings were confirmed by increased hospital admission rates with these diagnoses and more frequent prescriptions for inhalation medicine and antibiotics in participants with ILA. Conclusions: Individuals with ILA are more likely to receive a diagnosis and treatment for several respiratory diseases, including interstitial lung disease, COPD, pneumonia, lung cancer and respiratory failure during long-term follow-up.

show abstract

Low dose CT detected interstitial lung abnormalities in a population with low asbestos exposure

Harris

Lim²,

Moodley³

et al. 2021

American J Industrial Med

View full text Add to dashboard Cite

Background The use of low dose CT (LDCT) chest is becoming more widespread in occupationally exposed populations. There is a knowledge gap as to heterogeneity in severity and the natural course of asbestosis after low levels of exposure. This study reports the characteristics of LDCT‐detected interstitial lung abnormalities (ILA). Methods The Asbestos Review Program offers annual LDCT, health assessments, and pulmonary function tests to an asbestos‐exposed cohort. Asbestosis was defined using the Helsinki Consensus statement and the presence of ILA defined using a protocol for occupational CT reports. At least two of three pulmonary function tests: forced expiratory volume in 1 s (FEV1); forced vital capacity (FVC); and diffusion capacity for carbon monoxide (DLco) were required for analysis of physiological decline. Results From 1513 cases, radiological ILA was present in 485 (32%). The cohort was 83.5% male with a median age of 68.3 years and a median (IQR) asbestos exposure of 0.7 (0.09–2.32) fiber/ml‐year. A mixed occupation, mixed asbestos fiber cohort comprised the majority of the cohort (65.8%). Of those with ILA, 40 (8.2%) had an FVC decline of ≥10% and 30 (6.2%) had a DLco decline of ≥15% per year. Time since first exposure, increasing tobacco exposure and reported dyspnea were independently associated with the presence of ILA. Conclusions In this population with relatively low asbestos exposure, LDCT‐detected ILA that fits criteria for asbestosis is common, but physiological decline is not. This mild chronic stable phenotype of asbestos‐associated ILA contrasts with the traditionally accepted views that asbestosis requires high exposures.

show abstract

Interstitial lung abnormalities are associated with increased mortality in smokers

Cited by 60 publications

References 17 publications

Interstitial lung abnormalities in the Queensland Lung Cancer Screening Study: prevalence and progression over 2 years of surveillance

Interstitial lung abnormalities in the Queensland Lung Cancer Screening Study: prevalence and progression over 2 years of surveillance

Increased respiratory morbidity in individuals with interstitial lung abnormalities

Low dose CT detected interstitial lung abnormalities in a population with low asbestos exposure

Contact Info

Product

Resources

About