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D. Lynch



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    MA05 - Innovative Techniques in Pulmonology and the Impact on Lung Cancer (ID 378)

    • Event: WCLC 2016
    • Type: Mini Oral Session
    • Track: Pulmonology
    • Presentations: 1
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      MA05.07 - Identifying Comorbid Disease on Chest CT Scans in a Lung Cancer Screening-Eligible Cohort (ID 5764)

      16:42 - 16:48  |  Author(s): D. Lynch

      • Abstract
      • Presentation
      • Slides

      Background:
      Lung cancer screening (LCS) with chest CT scans in high-risk smokers has been demonstrated to save lives. Medicare and private insurers now cover these scans for beneficiaries under specific criteria. However, most smokers will die of comorbid smoking-related diseases rather than lung cancer itself. Important information about comorbid conditions is available on screening chest CT scans, but the prevalence of these comorbidities has not been comprehensively assessed.

      Methods:
      COPDGene subjects from the Phase 1 visit who met USPSTF criteria for LCS (age > 55, >30 pack years smoking, current or former smokers within 15 years of smoking cessation or current smokers) were assessed for coronary calcification, emphysema, gas trapping, airway wall thickening and vertebral bone density on standard dose CT scans. A new diagnosis of emphysema, osteoporosis, or cardiovascular disease was assumed when there was no self-report of diagnosis or medication use.

      Results:
      In 76% of CT scans from LCS-eligible COPDGene subjects, we found abnormal emphysema (>5% low attenuation area @-950 Hounsfield units), airway wall thickening or gas trapping (>20% low attenuation area @-856 Hounsfield units). Osteoporosis was identified in 54% of all CT scans, and abnormal coronary artery calcium was present in 51%. In non-COPD smokers a new diagnosis of emphysema, osteoporosis or coronary calcification was found in 741 (48%) subjects. Overall, 75% of LCS eligible CT scans showed one or more non-cancer diagnoses.

      Conclusion:
      Enhanced readings of the lung cancer screening scans could identify individuals with previously undiagnosed osteoporosis, atherosclerotic heart disease, emphysema and COPD. Identification and treatment for these conditions may reduce morbidity and mortality, improve quality of life and enhance smoking cessation.

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