The importance of low-dose CT screening to identify emphysema in asymptomatic participants with and without a prior diagnosis of COPD.

Autor: Steiger D; Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine, Mount Sinai St. Lukes, Mount Sinai West, Mount Sinai Beth Israel, New York, NY, United States of America., Siddiqi MF; Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine, Mount Sinai St. Lukes, Mount Sinai West, Mount Sinai Beth Israel, New York, NY, United States of America., Yip R; Department of Radiology, Icahn School of Medicine, Mount Sinai Hospital, New York, NY, United States of America., Yankelevitz DF; Department of Radiology, Icahn School of Medicine, Mount Sinai Hospital, New York, NY, United States of America., Henschke CI; Department of Radiology, Icahn School of Medicine, Mount Sinai Hospital, New York, NY, United States of America; Phoenix Veterans Health Care System, Phoenix, AZ, United States of America. Electronic address: Claudia.Henschke@mountsinai.org.
Jazyk: angličtina
Zdroj: Clinical imaging [Clin Imaging] 2021 Oct; Vol. 78, pp. 136-141. Date of Electronic Publication: 2021 Mar 20.
DOI: 10.1016/j.clinimag.2021.03.012
Abstrakt: Purpose: Chronic Obstructive Pulmonary Disease (COPD) includes chronic bronchitis, small airways disease, and emphysema. Diagnosis of COPD requires spirometric evidence and may be normal even when small airways disease or emphysema is present. Emphysema increases the risk of exacerbations, and is associated with all-cause mortality and increased risk of lung cancer. We evaluated the prevalence of emphysema in participants with and without a prior history of COPD.
Methods: We reviewed a prospective cohort of 52,726 subjects who underwent baseline low dose CT screening for lung cancer from 2003 to 2016 in the International Early Lung Cancer Action Program.
Results: Of 52,726 participants, 23.8%(12,542) had CT evidence of emphysema. Of these 12,542 participants with emphysema, 76.5%(9595/12,542) had no prior COPD diagnosis even though 23.6% (2258/9595) had moderate or severe emphysema. Among 12,542 participants, significant predictors of no prior COPD diagnosis were: male (OR = 1.47, p < 0.0001), younger age (OR age10  = 0.72, p < 0.0001), lower pack-years of smoking (OR 10pack-years  = 0.90, p < 0.0001), completed college or higher (OR = 1.54, p < 0.0001), no family history of lung cancer (OR = 1.12, p = 0.04), no self-reported cardiac disease (OR = 0.76, p = 0.0003) or hypertension (OR = 0.74, p < 0.0001). The severity of emphysema was significantly lower among the 9595 participants with no prior COPD diagnosis, the OR for moderate emphysema was OR moderate  = 0.58(p = 0.0007) and for severe emphysema, it was OR severe  = 0.23(p < 0.0001).
Conclusion: Emphysema was identified in 23.8% participants undergoing LDCT and was unsuspected in 76.5%. LDCT provides an opportunity to identify emphysema, and recommend smoking cessation.
(Copyright © 2021. Published by Elsevier Inc.)
Databáze: MEDLINE
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