Chest
Original ResearchLung CancerAssessing the Relationship Between Lung Cancer Risk and Emphysema Detected on Low-Dose CT of the Chest
Section snippets
Materials and Methods
The study was conducted using data from a prospective cohort of individuals enrolled in a lung cancer screening study using LDCT from September 2000 to December 2005.8 Eligibility criteria included age ≥ 40 years, > 10 pack-year smoking history, and no symptoms of lung cancer. The study protocol consisted of a baseline LDCT of the chest followed by annual repeat studies for up to 5 years. All patients underwent spirometry at enrollment and a baseline standardized questionnaire to collect
Results
A total of 1,166 individuals were included in the study. Baseline characteristics of the study participants are shown in Table 1. All participants were white western Europeans, mean age was 54 ± 8 years, and 74% were male. The median number of pack-years smoked was 33 (IQR: 22 pack-years). Overall, 29% (95% CI, 26 to 31%) of the subjects had emphysema on baseline LDCT and 25% (95% CI, 22 to 27%) had airway obstruction on spirometry (Fig 1). Fifty-three percent of the participants with emphysema
Discussion
Results of this prospective cohort study of current and former smokers suggest that the presence of emphysema on LDCT is associated with an increased risk for lung cancer. Stratified and multivariate analyses showed that this association was significant even after controlling for the presence of airway obstruction on spirometry, suggesting that emphysema on LDCT is an independent risk factor for lung cancer. This information can help identify patients at high risk for lung cancer who may
Acknowledgments
The authors thank Elena De Miguel, RN, and Teresa Jiménez, RN, for performing the pulmonary function tests.
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The study was approved by the Ethics Committee of the University Clinic of Navarra.
This work was funded in part by the Spanish Ministry of Health (FIS project PI04/2404) and the Department of Health of the Government of Navarra.
The authors have no conflicts of interest to disclose.