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Spirometry Suggests COPD for Many at Lung Cancer Screening

57 percent have spirometry findings consistent with COPD, 67 percent do not have prior history of COPD

MONDAY, March 16, 2020 (HealthDay News) — Many individuals undergoing low-dose computed tomography (LDCT) lung cancer screening (LCS) have spirometry findings consistent with chronic obstructive pulmonary disease (COPD), according to a study published online March 13 in the Annals of the American Thoracic Society.

Mamta Ruparel, M.B.B.S., Ph.D., from University College London, and colleagues examined associations between symptoms, comorbidities, spirometry, and emphysema in 968 participants enrolled in the Lung Screen Uptake Trial who were eligible for LCS and offered LDCT.

The researchers found that 57 percent of the participants had prebronchodilator spirometry consistent with COPD. Sixty-seven percent were termed undiagnosed and did not have a prior history of COPD. In those with known and undiagnosed COPD, the prevalence of emphysema was 73 and 68 percent, respectively. Of those with undiagnosed COPD, 32 percent had no emphysema on LDCT. Compared with the undiagnosed COPD group, inhaler use and symptoms were more common in the known group (63 versus 33 percent with persistent cough; 73 versus 33 percent with dyspnea). In all groups, comorbidities were common. The adjusted odds of respiratory symptoms were more significant for airflow obstruction than for emphysema.

“Reliance on CT alone to diagnose COPD risks [is] missing individuals who may actually have this condition, while over-diagnosing others,” Ruparel said in a statement. “Since individuals at risk for lung cancer are also at risk for COPD, we recommend including spirometry in low-dose CT lung cancer screening programs, in order to assist in making accurate diagnoses.”

Several authors disclosed financial ties to the pharmaceutical industry.

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