Prevalence of incidental interstitial lung disease in the Manchester lung cancer screening pilot
Barber, P. V.
Crosbie, P. A. J.
AffiliationManchester Thoracic Oncology Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom,
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AbstractIntroduction: 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.
CitationBalata 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.
TypeMeetings and Proceedings