Spirometry performed as part of the Manchester community-based lung cancer screening programme detects a high prevalence of airflow obstruction in individuals without a prior diagnosis of COPD.


Journal

Thorax
ISSN: 1468-3296
Titre abrégé: Thorax
Pays: England
ID NLM: 0417353

Informations de publication

Date de publication:
08 2020
Historique:
received: 18 05 2019
revised: 29 04 2020
accepted: 30 04 2020
pubmed: 24 5 2020
medline: 21 8 2020
entrez: 24 5 2020
Statut: ppublish

Résumé

COPD is a major cause of morbidity and mortality in populations eligible for lung cancer screening. We investigated the role of spirometry in a community-based lung cancer screening programme. Ever smokers, age 55-74, resident in three deprived areas of Manchester were invited to a 'Lung Health Check' (LHC) based in convenient community locations. Spirometry was incorporated into the LHCs alongside lung cancer risk estimation (Prostate, Lung, Colorectal and Ovarian Study Risk Prediction Model, 2012 version (PLCO 99.4% (n=2525) of LHC attendees successfully performed spirometry; mean age was 64.1±5.5, 51% were women, 35% were current smokers. 37.4% (n=944) had airflow obstruction of which 49.7% (n=469) had no previous diagnosis of COPD. 53.3% of those without a prior diagnosis were symptomatic (n=250/469). After multivariate analysis, the detection of airflow obstruction without a prior COPD diagnosis was associated with male sex ( Incorporating spirometry into a community-based targeted lung cancer screening programme is feasible and identifies a significant number of individuals with airflow obstruction who do not have a prior diagnosis of COPD.

Sections du résumé

BACKGROUND
COPD is a major cause of morbidity and mortality in populations eligible for lung cancer screening. We investigated the role of spirometry in a community-based lung cancer screening programme.
METHODS
Ever smokers, age 55-74, resident in three deprived areas of Manchester were invited to a 'Lung Health Check' (LHC) based in convenient community locations. Spirometry was incorporated into the LHCs alongside lung cancer risk estimation (Prostate, Lung, Colorectal and Ovarian Study Risk Prediction Model, 2012 version (PLCO
RESULTS
99.4% (n=2525) of LHC attendees successfully performed spirometry; mean age was 64.1±5.5, 51% were women, 35% were current smokers. 37.4% (n=944) had airflow obstruction of which 49.7% (n=469) had no previous diagnosis of COPD. 53.3% of those without a prior diagnosis were symptomatic (n=250/469). After multivariate analysis, the detection of airflow obstruction without a prior COPD diagnosis was associated with male sex (
CONCLUSIONS
Incorporating spirometry into a community-based targeted lung cancer screening programme is feasible and identifies a significant number of individuals with airflow obstruction who do not have a prior diagnosis of COPD.

Identifiants

pubmed: 32444437
pii: thoraxjnl-2019-213584
doi: 10.1136/thoraxjnl-2019-213584
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

655-660

Informations de copyright

© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Haval Balata (H)

Manchester Thoracic Oncology Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK haval.balata@mft.nhs.uk.
Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK.

Jonathan Harvey (J)

Manchester Thoracic Oncology Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.

Phil V Barber (PV)

Manchester Thoracic Oncology Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.

Denis Colligan (D)

Manchester Health and Care Commissioning, Manchester, UK.

Rebecca Duerden (R)

Manchester Thoracic Oncology Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.

Peter Elton (P)

Greater Manchester Health & Social Care Partnership, Manchester, UK.

Matthew Evison (M)

Manchester Thoracic Oncology Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.

Melanie Greaves (M)

Manchester Thoracic Oncology Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.

John Howells (J)

Department of Radiology, Royal Preston Hospital, Preston, Lancashire, UK.

Klaus Irion (K)

Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK.

Devinda Karunaratne (D)

Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK.

Stuart Mellor (S)

Department of Radiology, Royal Blackburn Hospital, Blackburn, Lancashire, UK.

Tom Newton (T)

Department of Radiology, Royal Blackburn Hospital, Blackburn, Lancashire, UK.

Richard Sawyer (R)

Manchester Thoracic Oncology Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.

Anna Sharman (A)

Manchester Thoracic Oncology Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.

Elaine Smith (E)

Manchester Thoracic Oncology Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.

Ben Taylor (B)

Department of Radiology, Christie NHS Foundation Trust, Manchester, UK.

Sarah Taylor (S)

Manchester Health and Care Commissioning, Manchester, UK.

Janet Tonge (J)

Manchester Health and Care Commissioning, Manchester, UK.

Anna Walsham (A)

Department of Radiology, Salford Royal NHS Foundation Trust, Salford, UK.

James Whittaker (J)

Department of Radiology, Stockport NHS Foundation Trust, Stockport, UK.

Joergen Vestbo (J)

Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK.

Richard Booton (R)

Manchester Thoracic Oncology Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK.

Phil A Crosbie (PA)

Manchester Thoracic Oncology Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
Division of Cancer Sciences, University of Manchester, Manchester, UK.

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