Identifying Smoking-Related Disease on Lung Cancer Screening CT Scans: Increasing the Value
| Autor: | Edwin J.R. van Beek, John E. Hokanson, Stephen M. Humphries, James H. Finigan, MeiLan K. Han, Gregory L. Kinney, Terri H. Beaty, Elizabeth Kern, Debra S. Dyer, Song Shou Mao, Russell P. Bowler, James D. Crapo, Douglas Curran-Everett, Barry J. Make, Katherine E Lowe, David A. Lynch, Elizabeth A. Regan, Edwin K. Silverman, Matthew J. Budoff, COPDGene Investigators, Jeffrey L. Curtis |
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| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty lung cancer screenings COPDGene® Investigators medicine.medical_treatment Osteoporosis Disease 030204 cardiovascular system & hematology comorbidities chronic obstructive pulmonary disease 03 medical and health sciences 0302 clinical medicine Internal medicine Cancer screening COPD Medicine Adverse effect Original Research business.industry medicine.disease Pneumonia 030228 respiratory system smoking-related disease Smoking cessation business Lung cancer screening |
| Zdroj: | Chronic obstructive pulmonary diseases (Miami, Fla.), vol 6, iss 3 |
| ISSN: | 2372-952X |
| DOI: | 10.15326/jcopdf.6.3.2018.0142 |
| Popis: | Author(s): Regan, Elizabeth A; Lowe, Katherine E; Make, Barry J; Lynch, David A; Kinney, Gregory L; Budoff, Matthew J; Mao, Song Shou; Dyer, Debra; Curtis, Jeffrey L; Bowler, Russell P; Han, MeiLan K; Beaty, Terri H; Hokanson, John E; Kern, Elizabeth; Humphries, Stephen; Curran-Everett, Douglas; van Beek, Edwin JR; Silverman, Edwin K; Crapo, James D; Finigan, James H; COPDGene® Investigators | Abstract: BackgroundLung cancer screening (LCS) via chest computed tomography (CT) scans can save lives by identifying early-stage tumors. However, most smokers die of comorbid smoking-related diseases. LCS scans contain information about smoking-related conditions that is not currently systematically assessed. Identifying these common comorbid diseases on CT could increase the value of screening with minimal impact on LCS programs. We determined the prevalence of 3 comorbid diseases from LCS eligible scans and quantified related adverse outcomes.MethodsWe studied COPD Genetic Epidemiology study (COPDGene®) participants (n=4078) who met criteria for LCS screening at enrollment (age g 55 years, and l 80 years, g 30 pack years smoking, current smoker or former smoker within 15 years of smoking cessation). CT scans were assessed for coronary artery calcification (CAC), emphysema, and vertebral bone density. We tracked the following clinically significant events: myocardial infarctions (MIs), strokes, pneumonia, respiratory exacerbations, and hip and vertebral fractures.ResultsOverall, 77% of eligible CT scans had one or more of these diagnoses identified. CAC (g 100 mg) was identified in 51% of scans, emphysema in 44%, and osteoporosis in 54%. Adverse events related to the underlying smoking-related diseases were common, with 50% of participants reporting at least one. New diagnoses of cardiovascular disease, emphysema and osteoporosis were made in 25%, 7% and 46%, of participants respectively. New diagnosis of disease was associated with significantly more adverse events than in participants who did not have CT diagnoses for both osteoporosis and cardiovascular risk.ConclusionsExpanded analysis of LCS CT scans identified individuals with evidence of previously undiagnosed cardiovascular disease, emphysema or osteoporosis that corresponded with adverse events. LCS CT scans can potentially facilitate diagnoses of these smoking-related diseases and provide an opportunity for treatment or prevention. |
| Databáze: | OpenAIRE |
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