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Lung Cancer |

Relationship Between Airflow Obstruction and Radiographic Emphysema and Clinical Follow-up of Subjects in a Lung Cancer Screening Program

Mark Yoder*, MD; Palmi Shah, MD; Edward Hong, MD; Michael Liptay, MD; James Mulshine, MD
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Rush University Medical Center, Chicago, IL


Chest. 2012;142(4_MeetingAbstracts):630A. doi:10.1378/chest.1387770
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Abstract

SESSION TYPE: Lung Cancer Posters I

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: The optimal population for lung cancer screening with low dose chest computed tomography (CT) remains to be determined. Recommended clinical follow-up was compared between groups of subjects with and without airflow obstruction and radiographic emphysema.

METHODS: A retrospective review of 100 subjects enrolled in a lung cancer screening study was performed. Recommended clinical follow-up was compared between subjects with and without airflow obstruction (defined as FEV1/VC <70%) and between subjects with and without radiographic emphysema (qualitative assessment by study radiologist).

RESULTS: At least one non-calcified nodule (NCN) was detected among 18 of the 33 subjects with airflow obstruction, compared to 17 of the 30 subjects without obstruction (54.5% vs. 56.7%). Follow-up prior to 12 months was recommended for 7 subjects with obstruction, compared to 4 subjects without obstruction (21.2% vs. 13.3%, p=0.41). Among the 9 subjects with at least moderate airflow obstruction (FEV1 <70% predicted), 6 had at least one NCN, and follow-up prior to 12 months was recommended in 4 (44.4%, p=0.04 compared to no obstruction group). At least one NCN was detected among 15 of the 32 subjects with radiographic emphysema, compared to 39 of the 68 subjects without emphysema (46.9% vs. 57.4%). Follow-up prior to 12 months was recommended for 7 subjects with emphysema, compared to 8 subjects without emphysema (21.9% vs. 11.8%, p=0.19). Among the 9 subjects with at least moderate radiographic emphysema, 6 had at least one NCN, and follow-up prior to 12 months was recommended in 4 (44.4%, p=0.01 compared to no emphysema group). None of the nodules that prompted early follow-up demonstrated growth suggestive of malignancy on repeat CT scan.

CONCLUSIONS: Early clinical follow-up was recommended more often for subjects with at least moderate airflow limitation or radiographic emphysema.

CLINICAL IMPLICATIONS: Subjects with obstructive lung disease are likely to require earlier follow-up than those without lung disease but do not appear to be at significant risk for newly-diagnosed lung cancer within the first year of screening.

DISCLOSURE: The following authors have nothing to disclose: Mark Yoder, Palmi Shah, Edward Hong, Michael Liptay, James Mulshine

lung cancer screening is considered research by many professional organizations at this point in time

Rush University Medical Center, Chicago, IL

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