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Association of COPD and/or emphysema in the lung cancer screening program in Fundación Jiménez Díaz Hospital

2022; Elsevier BV; Linguagem: Inglês

10.1183/13993003.congress-2022.3783

1872-8332

María De Los Ángeles Zambrano Chacón, Carlos Martínez‐Rivera, Germán Peces-Barba Romero, J Alfayate Sánchez, M F Troncoso Acevedo, Marcel José Rodríguez Guzmán, Abdulkader El Hachem Debek, Elena Cabezas Pastor, Erwin Javier Pinillos Robles, Diana Sánchez Mellado, Francisco Jos Laso del Hierro, M J Rodríguez Nieto, J J Salvatore Amorim Sortino,

Public Health and Environmental Issues

Introduction: Lung cancer (LC) is the leading cause of cancer death. After the NLST results demonstrated a 20% decrease in mortality rate of patients with low-dose computed tomography (LDCT), the implementation of early detection programs has been of special interest. Aim: To describe the characteristics of COPD and emphysema in patients with a diagnosis of LC included in the screening program (DEPRECAP) at the Fundación Jiménez Díaz Hospital. Methods: Retrospective study of a prospective cross-sectional cohort of subjects between 2014-2021. Inclusion criteria: age 55-75, smokers with pack-year index ≥30, with COPD and/or emphysema. Sociodemographic factors, pulmonary function tests, LDCT results and LC characteristics were recorded. The Syngo CT Pulmo 3D with automatic lobar segmentation, volume calculation and quantification of emphysema was used for LDCT analysis and SPSS 22.0 for statistical analysis. Results: 1602 patients were included, 52 with LC (2.37%). The prevalence of COPD is 75%, mainly GOLD 1-2 (65%) and 9.6% exacerbators. 80% were prescribed at least one bronchodilator, mainly LAMA (61.5%) or LABA (55.8%). Emphysema was observed in 86.5% of LDCT, in 50% centrilobular and in 88.9% in upper lobes. 73% of LC were early stage (I-II), mostly adenocarcinoma, with surgery being the most frequent treatment (44%) followed by SBRT (21%). During follow-up (mean 22 months (95% CI 18-27)) 13 patients died (25%). Conclusions: The prevalence of LC in our cohort is 2.37%, higher than in other programs as it includes high-risk patients (COPD and/or emphysema). Although 90% of our cohort had emphysema, its percentage in quantification is low (<10%) and with little impact on DLCO.