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

Abstract

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.