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Lung cancer screening provides an opportunity for early diagnosis and treatment of interstitial lung disease
  1. Richard J Hewitt1,2,
  2. Emily C Bartlett3,
  3. Rea Ganatra1,
  4. Haroun Butt1,
  5. Vasilis Kouranos1,4,
  6. Felix Chua1,4,
  7. Maria Kokosi1,4,
  8. Philip L Molyneaux1,2,
  9. Sujal R Desai3,4,
  10. Athol U Wells1,4,
  11. R Gisli Jenkins1,4,
  12. Elisabetta A Renzoni1,4,
  13. Samuel V Kemp3,5,
  14. Anand Devaraj3,4,
  15. Peter M George1,4
  1. 1Interstitial Lung Disease Unit, Royal Brompton & Harefield Hospitals, London, UK
  2. 2Faculty of Medicine, National Heart & Lung Institute, Imperial College, London, UK
  3. 3Department of Radiology, Royal Brompton and Harefield Hospitals, London, UK
  4. 4The Margaret Turner Warwick Centre for Fibrosing Lung Diseases, Imperial College London National Heart and Lung Institute, London, UK
  5. 5Airways Disease Section, Imperial College London National Heart and Lung Institute, London, UK
  1. Correspondence to Dr Peter M George, Interstitial Lung Disease Unit, Royal Brompton and Harefield Hospitals, London, UK; p.george{at}rbht.nhs.uk

Abstract

Interstitial lung abnormalities (ILA) can be incidentally detected in patients undergoing low-dose CT screening for lung cancer. In this retrospective study, we explore the downstream impact of ILA detection on interstitial lung disease (ILD) diagnosis and treatment. Using a targeted approach in a lung cancer screening programme, the rate of de novo ILD diagnosis was 1.5%. The extent of abnormality on CT and severity of lung function impairment, but not symptoms were the most important factors in differentiating ILA from ILD. Disease modifying therapies were commenced in 39% of ILD cases, the majority being antifibrotic therapy for idiopathic pulmonary fibrosis.

  • Idiopathic pulmonary fibrosis
  • Interstitial Fibrosis
  • Lung Cancer

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Footnotes

  • Twitter @RichardJHewitt, @DrPeteGeorge

  • Correction notice This article has been corrected since it was published Online First. The funding statement has been amended.

  • Contributors Study design: PMG, AD, RJH, ECB. Data acquisition: RJH, ECB, RG, HB, PMG, AD. Analysis, interpretation, manuscript drafting and revision and final approval of manuscript: RJH, ECB, RG, HB, VK, FC, MK, PLM, SRD, AUW, GJ, EAR, SVK, AD, PMG.

  • Funding RJH is supported by a NHLI funded Clinical Lectureship. The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests All authors have completed the ICMJE COI disclosure form and declare no support from any organisation for the submitted work. ECB, RG, HB, FC, MK, SVK report no competing interests. RJH reports participation in Boehringer Ingelheim educational events. VK reports speaker fees from Boehringer Ingelheim, Novartis, Roche. PLM reports grants from AstraZeneca, consulting fees from Hoffman-La Roche, Boehringer Ingelheim, AstraZeneca and speaker fees from Boehringer Ingelheim, Hoffman-La Roche. SRD reports consulting fees from Boehringer Ingelheim, Astra-Zeneca; participation on a data safety monitoring board for Astra-Zeneca. AUW reports consulting fees and speaker fees from Boehringer Ingelheim, Roche, and participation on a data safety monitoring or advisory board for Veracyte. RGJ reports grants from Astra Zeneca, Biogen, Galecto (all paid to institution); grants from GlaxoSmithKline, Nordic Biosciences, RedX, Pliant; consulting fees from Bristol Myers Squibb, Chiesi, Daewoong, Resolution Therapeutics, Pliant, Veracyte; speaker fees from Boehringer Ingelheim, Chiesi, Roche, PatientMPower, AztraZeneca; participation on a data safety monitoring board for Boehringer Ingelheim, Galapagos, Vicore; and is the President of Action for Pulmonary Fibrosis. EAR reports a grant, consulting fees and speaker fees from Boehringer Ingelheim (paid to institution); speaker fees from Roche and Chiesi (paid to institution); support to attend the ATS conference from Boehringer Ingelheim. AD reports consulting fees from Boehringer Ingelheim, Roche, Brainomix, Galapagos, Galecto, Vicore. PMG reports grants from Boehringer Ingelheim, MRC, Imperial College BRC; consulting fees from Boehringer Ingelheim, AstraZeneca; speaker fees from Boehringer Ingelheim, Roche, Cipla; support to attend the ATS and ERS from Boehringer Ingelheim and Roche; and is Medical Director of Brainomix LTD Stock options.

  • Provenance and peer review Not commissioned; externally peer reviewed.