Chronic obstructive pulmonary disease prevalence and prediction in a high-risk lung cancer screening population Journal Articles uri icon

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  • Abstract Background Chronic obstructive pulmonary disease (COPD) is an underdiagnosed condition sharing risk factors with lung cancer. Lung cancer screening may provide an opportunity to improve COPD diagnosis. Using Pan-Canadian Early Detection of Lung Cancer (PanCan) study data, the present study sought to determine the following: 1) What is the prevalence of COPD in a lung cancer screening population? 2) Can a model based on clinical and screening low-dose CT scan data predict the likelihood of COPD? Methods The single arm PanCan study recruited current or former smokers age 50–75 who had a calculated risk of lung cancer of at least 2% over 6 years. A baseline health questionnaire, spirometry, and low-dose CT scan were performed. CT scans were assessed by a radiologist for extent and distribution of emphysema. With spirometry as the gold standard, logistic regression was used to assess factors associated with COPD. Results Among 2514 recruited subjects, 1136 (45.2%) met spirometry criteria for COPD, including 833 of 1987 (41.9%) of those with no prior diagnosis, 53.8% of whom had moderate or worse disease. In a multivariate model, age, current smoking status, number of pack-years, presence of dyspnea, wheeze, participation in a high-risk occupation, and emphysema extent on LDCT were all statistically associated with COPD, while the overall model had poor discrimination (c-statistic = 0.627 (95% CI of 0.607 to 0.650). The lowest and the highest risk decile in the model predicted COPD risk of 27.4 and 65.3%. Conclusions COPD had a high prevalence in a lung cancer screening population. While a risk model had poor discrimination, all deciles of risk had a high prevalence of COPD, and spirometry could be considered as an additional test in lung cancer screening programs. Trial registration (Clinical Trial Registration:, number NCT00751660, registered September 12, 2008)


  • Goffin, John
  • Pond, Gregory
  • Puksa, Serge
  • Tremblay, Alain
  • Johnston, Michael
  • Goss, Glen
  • Nicholas, Garth
  • Martel, Simon
  • Bhatia, Rick
  • Liu, Geoffrey
  • Schmidt, Heidi
  • Atkar-Khattra, Sukhinder
  • McWilliams, Annette
  • Tsao, Ming-Sound
  • Tammemagi, Martin C
  • Lam, Stephen

publication date

  • December 2020