Prevalence, Symptom Burden, and Underdiagnosis of Chronic Obstructive Pulmonary Disease in a Lung Cancer Screening Cohort

Quaife, Samantha L; Dickson, Jennifer; Horst, Carolyn; Tisi, Sophie; Hall, Helen; Taylor, Magali; Ahmed, Asia; Shaw, Penny; Burke, Stephen; Soo, May-Jan; Nair, Arjun; Devaraj, Anand; Sennett, Karen; Hurst, John R.; Duffy, Stephen W.; Navani, Neal; Bhowmik, Angshu; Baldwin, David R; Janes, Sam M.

doi:10.1513/annalsats.201911-857oc

Cited by 46 publications

(46 citation statements)

References 36 publications

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“…3,4 Using this approach, these lung cancer screening studies found that between 37% and 67% of their eligible smokers had airflow limitation consistent with COPD. 1,2 In keeping with many community-based studies of high-risk smokers, they also reported that between 50% and 70% of these high-risk smokers with airflow limitation had not yet been diagnosed clinically as having COPD.…”

mentioning

confidence: 55%

“…Recently published lung cancer screening programs from the United Kingdom have targeted deprived communities and included routine baseline spirometry. 1,2 Although not widely recommended, 3 advocates for screening spirometry in asymptomatic smokers have described this as a "Lung Health Check," an opportunity to identify COPD at a presymptomatic stage and basis for maintaining good lung health through targeted preventive measures. 3,4 Using this approach, these lung cancer screening studies found that between 37% and 67% of their eligible smokers had airflow limitation consistent with COPD.…”

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confidence: 99%

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Incorporating Baseline Lung Function in Lung Cancer Screening

Young

Gamble

Silvestri

2021

Chest

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confidence: 55%

mentioning

confidence: 99%

Incorporating Baseline Lung Function in Lung Cancer Screening

Young

Gamble

Silvestri

2021

Chest

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“…The remaining 610 participants had a ‘normal’ scan or had non-malignant findings that have been discussed elsewhere. 13 14 After a median follow-up of 1044 days, a total of 36 lung cancers (4.7%) were diagnosed. Of these, 17 ( 51.5% of those referred to the lung cancer clinic ) were diagnosed directly following the baseline LDCT and the remainder were diagnosed following further surveillance CT scans of indeterminate nodules in the 3-month (n=16, 17.4% of nodules in this group) or 12-month surveillance groups (n=3, 9.1% of nodules in this group).…”

Section: Resultsmentioning

confidence: 99%

Lung Screen Uptake Trial: results from a single lung cancer screening round

Quaife

Dickson

Horst

et al. 2020

Thorax

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The Lung Screen Uptake Trial tested a novel invitation strategy to improve uptake and reduce socioeconomic and smoking-related inequalities in lung cancer screening (LCS) participation. It provides one of the first UK-based ‘real-world’ LCS cohorts. Of 2012 invited, 1058 (52.6%) attended a ‘lung health check’. 768/996 (77.1%) in the present analysis underwent a low-dose CT scan. 92 (11.9%) and 33 (4.3%) participants had indeterminate pulmonary nodules requiring 3-month and 12-month surveillance, respectively; 36 lung cancers (4.7%) were diagnosed (median follow-up: 1044 days). 72.2% of lung cancers were stage I/II and 79.4% of non-small cell lung cancer had curative-intent treatment.

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“…As there is no defining clinical sign for AATD diagnosis, the use of targeted detection across a range of phenotypes has to be considered; this would be consistent with the more nuanced approach to screening now advocated ( Table 1 ). It is conceivable that AATD could be identified through screening for other lung pathologies; for example, if small airways disease (SAD) or emphysema were seen on a CT scan done for lung cancer screening it might trigger tests for COPD 38 and AATD. Typically cancer screening focuses on heavy smokers though, so there would be risks to this approach, mainly missing cases who have never smoked or have low smoke exposure, and in some countries questions have been raised about the cost-effectiveness of such CT based programs.…”

Section: Diagnosismentioning

confidence: 99%

<p>Obstacles to Early Diagnosis and Treatment of Alpha-1 Antitrypsin Deficiency: Current Perspectives</p>

Quinn¹,

Ellis²,

Pye³

et al. 2020

TCRM

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This review summarizes the current research and outlooks regarding the obstacles to diagnosing and treating early alpha-1-antitrypsin deficiency (AATD). It draws on prior systematic reviews and expert surveys to discover precisely what difficulties exist in early diagnosis and treatment of AATD and elucidate potential solutions to ease these difficulties. The perceived rarity of AATD may translate to a condition poorly understood by primary care physicians, and even many respiratory physicians, which results in opportunities for diagnosis being missed, especially in mild or asymptomatic patients. There are diagnostic techniques involving biomarkers and home testing methods which could improve the rate of early diagnosis. With respect to treatment, AATD involves treating two separate pathologies, lung disease and liver disease. The only specific AATD treatment, augmentation therapy, has proven ability in treating lung disease but not liver disease. Alpha-1-antitrypsin (AAT) synthesized in the liver can form damaging polymers that also result in reduced circulating AAT levels and, whilst liver transplantation is used to effectively treat AATD, it is inappropriate in early disease. Novel therapeutic areas such as gene editing and increasing autophagy are therefore being researched as future treatments. Ultimately, diagnosis and treatment are intrinsically linked in AATD, with earlier diagnosis leading to better treatment options and thus better patient outcomes.

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Prevalence, Symptom Burden, and Underdiagnosis of Chronic Obstructive Pulmonary Disease in a Lung Cancer Screening Cohort

Cited by 46 publications

References 36 publications

Incorporating Baseline Lung Function in Lung Cancer Screening

Incorporating Baseline Lung Function in Lung Cancer Screening

Lung Screen Uptake Trial: results from a single lung cancer screening round

<p>Obstacles to Early Diagnosis and Treatment of Alpha-1 Antitrypsin Deficiency: Current Perspectives</p>

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