title: Exploring the impact of screening with low-dose CT on lung cancer mortality in mild to moderate COPD patients: a pilot study.
abstract: BACKGROUND
  COPD is an independent risk factor for lung cancer, especially in patients with mild to moderate disease.
  
  
  OBJECTIVE
  To determine if performing lung cancer screening in GOLD 1 and 2 COPD patients, results in reduced lung cancer mortality.
  
  
  METHODS
  This study compared patients with mild to moderate COPD from 2 cohorts matched for age, gender, BMI, FEV1%, pack-yrs history and smoking status. The screening group (SG) had an annual low dose computed tomography (LDCT). The control group (CG) was prospectively followed with usual care. Lung cancer incidence and mortality densities were compared between groups.
  
  
  RESULTS
  From an initial sample of 410 (SG) and 735 (CG) patients we were able to match 333 patients from each group. At the same follow-up time lung cancer incidence density was 1.79/100 person-years in the SG and 4.14/100 person-years in the CG (p = 0.004). The most frequent histological type was adenocarcinoma in both SG and CG (65% and 46%, respectively), followed by squamous cell carcinoma (25% and 37%, respectively). Eighty percent of lung cancers in the SG (16/20) were diagnosed in stage I, and all of CG cancers (35/35) were in stage III or IV. Mortality incidence density from lung cancer (0.08 vs. 2.48/100 person-years, p < 0.001) was lower in the SG.
  
  
  CONCLUSIONS
  This pilot study in patients with mild to moderate COPD suggests that screening with LDCT detects lung cancer in early stages, and could decrease lung cancer mortality in that high risk group. Appropriately designed studies should confirm these important findings.
authors: Pulmonary Department, Clínica Universidad de Navarra, Pamplona 31200, Spain. jpdetorres@unav.es
authors: Juan P
authors: JP
authors: de-Torres
authors: Ciro
authors: C
authors: Casanova
authors: Jose M
authors: JM
authors: Marín
authors: Jorge
authors: J
authors: Zagaceta
authors: Ana B
authors: AB
authors: Alcaide
authors: Luis M
authors: LM
authors: Seijo
authors: Arantza
authors: A
authors: Campo
authors: Santiago
authors: S
authors: Carrizo
authors: Usua
authors: U
authors: Montes
authors: Elizabeth
authors: E
authors: Cordoba-Lanus
authors: Rebeca
authors: R
authors: Baz-Dávila
authors: Armando
authors: A
authors: Aguirre-Jaime
authors: Bartolome R
authors: BR
authors: Celli
authors: Javier J
authors: JJ
authors: Zulueta
mesh_terms: D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D010865:Pilot Projects; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000503:physiopathology; D011829:Radiation Dosage; D013030:Spain / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000379:methods; D014797:Vital Capacity / Q000502:physiology