Emphysema Can Be Detected During Lung Cancer Screenings

Thoracic computed tomography (CT) scans for lung cancer screening (LCS) can detect emphysema, according to an article published in Annals of the American Thoracic Society.

“The joint detection of these two frequent lethal tobacco-related diseases provides a new opportunity to manage these diseases in a more cohesive fashion that may enhance the public investment related to the delivery of national LCS,” wrote corresponding author James Mulshine, Center for Healthy Aging. Rush University in Chicago, Illinois, and coauthors.

Two recent reports analyzed data from the IELCAP (International Early Lung Cancer Program) and NLST (National Lung Screening Trial) cohorts. The two cohorts included more than 79,000 participants undergoing LCS. The baseline LCS scans from the two cohorts detected emphysema among 23.8% in the IELAP cohort and 31% in the NLST cohort. The majority of the participants had no prior knowledge of this lung disease.

According to the new Centers for Medicare and Medicaid Services, 15 million people are now eligible for LCS. Considering an emphysema frequency of 20% to 30%, a full implementation of CT-based LCS in which 75% were asymptomatic screening participants, as many as 2.6 to 3 million would learn that they have emphysema detected. To manage these patients, steps to standardize radiological reporting of emphysema and measures to improve communication about the frequency of emphysema detection within the LCS process are critical priorities. Thus, LCS provides a new setting for comprehensive research.

Sharing personalized CT scan results with an LCS participant, mainly when new findings of emphysema are detected in individuals who continue to smoke, can be used as evidence to reinforce the importance of smoking cessation. Annual LCS can also provide a valuable research opportunity to explore the benefits of other preventive interventions.

“Detecting emphysema, like detecting early-stage lung cancer, may allow important opportunities for tobacco-exposed individuals to manage their lung health using safe and economical preventive interventions,” wrote the study authors.

Reference

Mulshine JL, Aldigé CR, Ambrose LF, et al. Emphysema detection in the course of lung cancer screening: optimizing a rare opportunity to impact population health. Ann Am Thorac Soc. 2023;20(4):499-503. doi:10.1513/AnnalsATS.202207-631PS