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• W3206811929 abstract "Lung cancer screening (LCS) via chest computed tomography (CT) scans can save lives by identifying early-stage tumors. On the other hand, because cigarette smoking affects multiple systems, most participants die of comorbid smoking-related diseases, which may be unknown to the patient. Several of these diseases are treatable with an expectation of reduced mortality and improvement of quality of life. LCS scans provide information about smoking-related conditions that are not currently systematically assessed. We developed one simple free software CT scan assessment protocol (Check Lung Protocol) that evaluates the presence of six comorbid diseases during LCS. This study is a retrospective examination for the presence of six comorbidities of 774 low-dose CT scans from patients who underwent LCS between 2016 and 2020. Patients included met the criteria for LCS (within 55 to 80 years old at the time of enrollment, with 30 pack-years of smoking history or former smokers who quit smoking until the previous 15 years). The comorbidities searched for on scans were coronary artery calcification (CAC), sarcopenia, interstitial lung disease (ILD), emphysema, osteoporosis, and hepatic steatosis. Past medical records were reviewed to describe if these comorbidities were previously non-diagnosed. The clinic characteristics of each participant were identified as the mean of densitovolumetry values with t-test and q-square. About scans, CT data were acquired in full expiration and evaluated by two different radiologists. To validate the radiologist’s interpretation, the kappa coefficient (k) was calculated to analyze the agreement index in CAC, and the intraclass correlation coefficient (ICC) to assess the correlation of the reliability of measures for liver, spleen, and bone density. Our sample had a mean age of 64, and 602 (77.7%) were male patients. We found that 671 (86.6%) of the CT scans for LCS had at least one or more comorbidities. CAC (> 100mg) was identified in 41.9% CT scans, sarcopenia was found in 9.9%, osteoporosis was present in 44.2%, and hepatic steatosis in 40.7% of the cases. Among lung diseases evaluated, emphysema was observed in 66.3% of scans and ILD in 32.2%. New diagnoses of cardiovascular disease were made in 25% of patients, emphysema in 7%, and osteoporosis in 46%. Kappa coefficient for CAC was 0.906 (p < 0.001) and ICC measurements, with p < 0.001 for all of them, was 0.88 for liver density, 0.93 for spleen density and 0.96 for bone density. We observed a strong significant relation between sarcopenia, CAC, and mortality. Our data demonstrated a high prevalence of previously undiagnosed cardiovascular disease, emphysema, ILD, sarcopenia, osteoporosis, and hepatic steatosis in CT scans from LCS patients. Check Lung Protocol can potentially facilitate diagnoses of these additional pathologies and provide an opportunity for treatment or prevention of progression for high morbimortality conditions. Data from this study can increase the value of screening with minimal impact on LCS programs." @default.
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• W3206811929 date "2021-10-01" @default.
• W3206811929 modified "2023-10-14" @default.
• W3206811929 title "FP13.04 CHECK Lung Protocol: CT Lung Cancer Screening is Useful to Adjuvant Comorbid Diseases Diagnosis" @default.
• W3206811929 doi "https://doi.org/10.1016/j.jtho.2021.08.252" @default.
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