Surveillance of chronic obstructive pulmonary disease in high-risk individuals by using regional lung cancer mass screening

• Published in: International journal of chronic obstructive pulmonary disease Vol. 9; no. default; pp. 647 - 656
• Main Authors: Sekine, Yasuo, Yanagibori, Ryoko, Suzuki, Kiminori, Sugiyama, Sonomi, Yamaji, Haruko, Ishibashi, Michiko, Fujisawa, Takehiko
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2014; Dove Medical Press Ltd; Dove Medical Press
• Subjects: Adult; Age; Age Factors; Aged; Aged, 80 and over; Angina pectoris; Cancer; Candidates; Cardiovascular disease; Chi-Square Distribution; Chronic obstructive pulmonary disease; Diabetes; Diagnosis; Dyspnea; Emphysema; Female; Health insurance; Heart attacks; Humans; Hypertension; Japan - epidemiology; Life Style; Lifestyles; Logistic Models; Lung cancer; Lung diseases, Obstructive; Lung Neoplasms - diagnosis; Lung Neoplasms - epidemiology; Male; Mass Screening - methods; Medical screening; Methods; Middle Aged; Original Research; Osteoporosis; Predictive Value of Tests; Program Evaluation; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - epidemiology; Questionnaires; Radiography; Respiratory Function Tests; Risk Assessment; Risk Factors; Sentinel health events; Severity of Illness Index; Sex Factors; Smoking; Smoking - adverse effects; Time Factors; Japan; mass screening; lung neoplasms; respiratory function tests; chronic obstructive pulmonary disease
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/copd.s62053

Patients with chronic obstructive pulmonary disease (COPD) are at risk for lung cancer; the diseases have common etiologies, including cigarette smoking. We aimed to clarify the effectiveness of COPD detection using a regional mass-screening program for lung cancer. A total of 7,067 residents of Togane, Chiba, Japan received lung cancer screening between May and July, 2011. We defined four groups of possible COPD candidates: group A (n=358), positive smoking history, positive chronic respiratory symptoms; group B (n=766), positive smoking history, positive lifestyle-related disease; group C (n=75), passive smoking history, positive chronic respiratory symptoms; and group D (n=301), passive smoking history, positive lifestyle-related disease. Candidates underwent on-site pulmonary function testing (PFT). The criteria for COPD candidates were fulfilled in 1,686 of 7,067 individuals (23.9%); 1,500 participants underwent PFT (89%), and 171 (11.4%) were diagnosed with COPD. The overall COPD detection rate was 2.4%. The frequency of COPD was significantly higher in groups A and B than in groups C and D (P=0.048); however, the distribution of COPD grades was similar among the groups (P=0.372). Multiple logistic regression analysis identified male sex, age 60 years or greater, and positive smoking history as risk factors for COPD. COPD screening using a community-based lung cancer-screening program may be effective for disease detection. Individuals who are 60 years of age or older with a positive smoking history should undergo PFT to detect COPD.