Open Collections

Goffin, John R; Pond, Gregory R; Puksa, Serge; Tremblay, Alain; Johnston, Michael; Goss, Glen; Nicholas, Garth; Martel, Simon; Bhatia, Rick; Liu, Geoffrey; Schmidt, Heidi; Atkar-Khattra, Sukhinder; McWilliams, Annette; Tsao, Ming-Sound; Tammemagi, Martin C; Lam, Stephen

BioMed Central

Background Chronic obstructive pulmonary disease (COPD) is an underdiagnosed condition sharing risk factors with lung cancer. Lung cancer screening may provide an opportunity to improve COPD diagnosis. Using Pan-Canadian Early Detection of Lung Cancer (PanCan) study data, the present study sought to determine the following: 1) What is the prevalence of COPD in a lung cancer screening population? 2) Can a model based on clinical and screening low-dose CT scan data predict the likelihood of COPD? Methods The single arm PanCan study recruited current or former smokers age 50–75 who had a calculated risk of lung cancer of at least 2% over 6 years. A baseline health questionnaire, spirometry, and low-dose CT scan were performed. CT scans were assessed by a radiologist for extent and distribution of emphysema. With spirometry as the gold standard, logistic regression was used to assess factors associated with COPD. Results Among 2514 recruited subjects, 1136 (45.2%) met spirometry criteria for COPD, including 833 of 1987 (41.9%) of those with no prior diagnosis, 53.8% of whom had moderate or worse disease. In a multivariate model, age, current smoking status, number of pack-years, presence of dyspnea, wheeze, participation in a high-risk occupation, and emphysema extent on LDCT were all statistically associated with COPD, while the overall model had poor discrimination (c-statistic = 0.627 (95% CI of 0.607 to 0.650). The lowest and the highest risk decile in the model predicted COPD risk of 27.4 and 65.3%. Conclusions COPD had a high prevalence in a lung cancer screening population. While a risk model had poor discrimination, all deciles of risk had a high prevalence of COPD, and spirometry could be considered as an additional test in lung cancer screening programs. Trial registration (Clinical Trial Registration: ClinicalTrials.gov, number NCT00751660 , registered September 12, 2008)

Article

eng

Vancouver : University of British Columbia Library

10.14288/1.0394994

Other UBC; Non UBC

10.1186/s12890-020-01344-y

Faculty

http://creativecommons.org/licenses/by/4.0/