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Prevalence of incidental interstitial lung disease in the Manchester lung cancer screening pilot
Balata, H. Hayton, C. Barber, P. V. Duerden, R. Evison, M. Greaves, M. Howells, J. Irion, K. Karunaratne, D. Leonard, C.
Balata, H.
Hayton, C.
Barber, P. V.
Duerden, R.
Evison, M.
Greaves, M.
Howells, J.
Irion, K.
Karunaratne, D.
Leonard, C.
Citations
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Abstract
Introduction: The Manchester lung cancer screening (LCS) pilot
is one of the first LCS implementation programmes in Europe. An
important issue to consider when planning for implementation is
the management of incidental findings. The incidence of interstitial
lung disease (ILD) in LCS is reported to be between 0.9% and 19.8%.
The presence of interstitial lung abnormalities (ILA) in screening is
associated with increased mortality and early intervention may be
of benefit. The aim of this study was to determine the prevalence of
ILD in the Manchester LCS pilot.
Methods: Details of the Manchester pilot have been previously
described. In brief, ever smokers, aged 55-74, were invited to a free
'Lung Health Check' (LHC). Those at risk of lung cancer (PLCOM2012
risk score ≥1.51%) were invited for annual LDCT screening over two
rounds. All scans were reported by thoracic radiologists. All reported
ILAs were discussed at the regional ILD-MDT and, if deemed
appropriate, offered clinical review at the ILD clinic.
Results: A total of 1384 individuals underwent screening LDCT at
the baseline round (T0) of which 1194 had a further scan at the
second round (T1). In total, 87 (6.3%) individuals had an ILA reported
on a screening scan (T0=70; T1=17). Of these, 38% (n=33) were
reported as fibrotic and 62% (n=54) non-fibrotic. Following MDT
discussion 50 (3.6%) individuals were offered an appointment at the
regional ILD clinic. Those not offered a clinical review had patterns
consistent with respiratory bronchiolitis or minor interstitial
changes and were asymptomatic with normal spirometry. Of those
offered clinic appointments 39 attended. Conclusion: Our study demonstrates the prevalence of ILD in a real
world LCS programme is significant and the potential impact this
can have on services will need to be considered when planning for
implementation.
Description
Date
2019
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Balata H, Hayton C, Barber PV, Duerden R, Evison M, Greaves M, et al. Prevalence of incidental interstitial lung disease in the Manchester lung cancer screening pilot. Lung Cancer. 2019;127:S23-S4.