TUESDAY, Oct. 25 (HealthDay News) -- Men with a history of heavy
smoking who have a CT scan to look for lung cancer could benefit
from a simultaneous check for chronic obstructive pulmonary disease
(COPD), Dutch researchers suggest.
It's estimated that smoking will cause more than 8 million
deaths a year around the world in the coming decades. In addition
to cardiovascular disease and cancer, COPD is a major cause of
death in heavy smokers. Yet, it is under-diagnosed, and deaths from
it are increasing, the researchers noted.
CT-based lung cancer screening "may provide an opportunity to
detect individuals with COPD at an early stage," said study author
Dr. Pim A. de Jong, a radiologist at the University Medical Center
"Early cessation of smoking can prevent COPD progression, underscoring the importance of early detection," de Jong said. "This CT-based detection may provide a possibility to enhance the cost-effectiveness of lung cancer screening with CT."
The report was published in the Oct. 26 issue of the
Journal of the American Medical Association.
For the study, de Jong's team looked for COPD in more than 1,000
men who took part in an ongoing lung cancer screening trial using
CT scans that ran from July 2007 to September 2008. The men also
underwent lung function tests that are standard screens for
Based on lung function tests, the researchers found 38 percent
of the men had COPD.
Using CT scans, de Jong's group looked for emphysema, a common
form of COPD characterized by air trapped in the lungs. They also
took into account the patient's weight and how many cigarettes each
patient smoked a day and whether he had quit or still smoked.
Using this criteria, they identified about 275 men with COPD and
85 with false-positive results, meaning they did not actually have
the condition. That means the CT test was able to correctly predict
COPD 76 percent of the time, the researchers reported.
This included men with mild, moderate and severe COPD, they
"Among men who were current or former heavy smokers, undergoing lung cancer screening with CT scanning identified a substantial proportion who had COPD, suggesting that this method may be helpful as an additional tool in detecting COPD," de Jong said.
Dr. Neil Schachter, medical director of the respiratory care
department at Mount Sinai School of Medicine in New York City, said
heavy smokers should be screened for COPD.
"The question is, is CT a useful way to screen for COPD," he said. "On the one hand, you are using an expensive tool to make a diagnosis that you could make with a simpler, cheaper tool, namely spirometry."
However, with CT scans becoming a standard screen for diagnosing
lung cancer, it might make sense to also use it to diagnose COPD,
A study in the June 30 issue of the
New England Journal of Medicine found that annual low-dose CT
scans cut the death rate from lung cancer by 20 percent in heavy
smokers and formerly heavy smokers, compared with those who get
annual chest X-rays.
"Lung cancer [detection] with CT scans is poised to take off. It may take off like a flash or it may crash and burn, we don't know that yet," he said. "If people are going to have this test anyway, then it would make sense that they be screened for COPD," Schachter said. "But there are a lot of ifs here."
Schachter noted that COPD is the third leading cause of death in
the United States, and of the 25 million with the condition only
half know they have it. Diagnosing COPD early means earlier
treatment and better outcomes, he said.
For more on COPD, visit the
U.S. Heart, Lung, and Blood Institute.
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