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Vol. 60. Issue 2.
Pages 95-100 (February 2024)
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Vol. 60. Issue 2.
Pages 95-100 (February 2024)
Original Article
Lung Cancer Screening in People With COPD: The Pamplona-IELCAP Experience
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Juan P. de-Torresa,b,c,
Corresponding author
jupa65@hotmail.com

Corresponding author.
, Ana Belén Alcaidea,b, Arancha Campoa,b,c, Javier J. Zuluetaa,d, Gorka Bastarrikae,b, Ana Ezpondae,b, Miguel Mesaf,b, Diego Murillof,b, María Rodriguezg,b, María del Mar Ocóna,b, Carmen Felguerosoa,b, Jesús Pueyoe,b, María Dolores Lozanoh,b, Luis M. Montuengai,j, Juan Bertok,b, María Teresa Perez-Warnisherk,b, Isberling Madeleine Di-Friscoa,b, Luis M. Seijok,b,l
a Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain
b Cancer Center Clinica Universidad de Navarra (CCUN), Pamplona, Spain
c Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
d Division of Pulmonary, Critical Care and Sleep Medicine/Department of Medicine, Mount Sinai Morningside Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
e Radiology Department, Clínica Universidad de Navarra, Pamplona, Spain
f Thoracic Surgery Department, Clínica Universidad de Navarra, Pamplona, Spain
g Thoracic Surgery Department, Clínica Universidad de Navarra, Madrid, Spain
h Pathology Department, Clínica Universidad de Navarra, Pamplona, Spain
i Solid Tumors Program, Center of Applied Medical Research (CIMA), Cancer Center Clinica Universidad de Navarra (CCUN), University of Navarra and IDISNA, Pamplona, Spain
j CIBERONC, Madrid, Spain
k Pulmonary Department, Clínica Universidad de Navarra, Madrid, Spain
l CIBERES, Madrid, Spain
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Tables (4)
Table 1. Characteristics of participants included in the analysis.
Table 2. Characteristics of participants with and without LC.
Table 3. Characteristics of participants diagnosed with LC.
Table 4. Uni and multivariable analysis exploring the factors associated with LC diagnosis.
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Additional material (1)
Abstract
Introduction

The Global Initiative for Obstructive Lung Disease (GOLD) recommends lung cancer screening for patients with Chronic Obstructive Pulmonary Disease (COPD), but data is lacking regarding results of screening in this high-risk population. The main goal of the present work is to explore if lung cancer screening with Low Dose Chest Tomography (LDCT) in people with COPD, allows lung cancer (LC) diagnosis in early stages with survival compatible with curative state.

Methods

This is a post hoc exploratory analysis. Pamplona International Early Lung Cancer Action Program (P-IELCAP) participants with a GOLD defined obstructive pattern (post bronchodilator FEV1/FVC<0.70) were selected for analysis. The characteristics of those who developed LC and their survival are described. A Cox proportional analysis explored the factors associated with LC diagnosis.

Results

Eight hundred and sixty-five patients (77% male, 93% in spirometric GOLD stage 1+2) were followed for 102±63 months. LC prevalence was 2.6% at baseline, with an annual LC diagnosis rate of 0.68%. Early-stage tumors predominated (74%) with a median survival (25–75th percentiles) of 139 (76–185) months. Cumulative tobacco exposure, FEV1%, and emphysema were the main predictors of an LC diagnosis. Eight (11%) patients with COPD had a second LC, most of them in early stage (92%), and 6 (8%) had recurrence. Median survival (25–75th percentiles) in these patients was 168 (108–191) months.

Conclusions

Lung cancer screening of selected high-risk participants with COPD allowed the LC diagnosis in early stages with survival compatible with curative state.

Keywords:
COPD
Lung cancer
Screening
Survival
Emphysema
Early

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