CT Scan in early detection of lung cancer in patients with chronic obstructive pulmonary disease: A retrospective monocentric study

Abstract

Objective: To explore the possible benefit of detecting lung cancer in COPD patients and to assess the pulmonologist's compliance with the Fleischner Society guidelines for management of pulmonary nodules. Methods: This monocentric retrospective study was approved by the institutional ethical Committee. Patients with COPD undergoing a CT scan between January 2010 and March 2017 were included. Depending on CT indication (respectively screening or other indications), patients were divided into Group 1 and 2. Follow-up intervals were compared to those recommended in the Fleischner Society guidelines. Data were compared between groups using Chisquared test, Student test, or Wilcoxon test when appropriate. Results: 254 patients were included (134 in Group 1 and 120 in Group 2). 235 opacities were found in 119 patients (47 %). 13 among 254 patients had a lung cancer; 9 in Group 1 (6.7 %) and 4 in Group 2 (3.3 %). The median follow-up by CT after nodule detection was six months regardless of their diameter or attenuation. No statistical significance was found between the observed follow-up and recommendations (P = 0.058). Conclusion: COPD in patients with a history of smoking is associated with a higher CT detection rate of lung cancer. This finding may be useful when evaluating selection criteria in lung screening programs. In contrast with the recommendations, CT detected nodules are followed-up regardless of their diameter and attenuation.