Diagnoses and treatments for participants with interstitial lung abnormalities detected in the Yorkshire Lung Screening Trial
Introduction Interstitial lung abnormalities (ILA) are relatively common incidental findings in participants undergoing low-dose CT screening for lung cancer. Some ILA are transient and inconsequential, but others represent interstitial lung disease (ILD). Lung cancer screening therefore offers the...
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BMJ Publishing Group
2023-07-01
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| Series: | BMJ Open Respiratory Research |
| Online Access: | https://bmjopenrespres.bmj.com/content/10/1/e001490.full |
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| author | Martyn P T Kennedy Bobby Bhartia Matthew E J Callister Paul Beirne Neil Hancock Philip A J Crosbie Suzanne Rogerson Rhian Gabe Bethany Shinkins Irene Simmonds Alison Boland Claire Eckert Claire Bradley Jason Lindop Sara Upperton Mike Darby Tim J T Sutherland |
| author_facet | Martyn P T Kennedy Bobby Bhartia Matthew E J Callister Paul Beirne Neil Hancock Philip A J Crosbie Suzanne Rogerson Rhian Gabe Bethany Shinkins Irene Simmonds Alison Boland Claire Eckert Claire Bradley Jason Lindop Sara Upperton Mike Darby Tim J T Sutherland |
| author_sort | Martyn P T Kennedy |
| collection | DOAJ |
| description | Introduction Interstitial lung abnormalities (ILA) are relatively common incidental findings in participants undergoing low-dose CT screening for lung cancer. Some ILA are transient and inconsequential, but others represent interstitial lung disease (ILD). Lung cancer screening therefore offers the opportunity of earlier diagnosis and treatment of ILD for some screening participants.Methods The prevalence of ILA in participants in the baseline screening round of the Yorkshire Lung Screening Trial is reported, along with the proportion referred to a regional ILD service, eventual diagnoses, outcomes and treatments.Results Of 6650 participants undergoing screening, ILA were reported in 169 (2.5%) participants. Following review in a screening review meeting, 56 participants were referred to the ILD service for further evaluation (0.8% of all screening participants). 2 participants declined referral, 1 is currently awaiting review and the remaining 53 were confirmed as having ILD. Eventual diagnoses were idiopathic pulmonary fibrosis (n=14), respiratory bronchiolitis ILD (n=4), chronic hypersensitivity pneumonitis (n=2), connective tissue disease/rheumatoid arthritis-related ILD (n=4), asbestosis (n=1), idiopathic non-specific interstitial pneumonia (n=1), sarcoidosis (n=1) and pleuroparenchymal fibroelastosis (n=1). Twenty five patients had unclassifiable idiopathic interstitial pneumonia. Overall, 10 people received pharmacotherapy (7 antifibrotics and 3 prednisolone) representing 18% of those referred to the ILD service and 0.15% of those undergoing screening. 32 people remain under surveillance in the ILD service, some of whom may require treatment in future.Discussion Lung cancer screening detects clinically significant cases of ILD allowing early commencement of disease-modifying treatment in a proportion of participants. This is the largest screening cohort to report eventual diagnoses and treatments and provides an estimate of the level of clinical activity to be expected by ILD services as lung cancer screening is implemented. Further research is needed to clarify the optimal management of screen-detected ILD.Trial registration number ISRCTN42704678. |
| format | Article |
| id | doaj-art-2c34ea09340e4ef38f12baf378bc072a |
| institution | DOAJ |
| issn | 2052-4439 |
| language | English |
| publishDate | 2023-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Respiratory Research |
| spelling | doaj-art-2c34ea09340e4ef38f12baf378bc072a2025-08-20T02:59:46ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392023-07-0110110.1136/bmjresp-2022-001490Diagnoses and treatments for participants with interstitial lung abnormalities detected in the Yorkshire Lung Screening TrialMartyn P T Kennedy0Bobby Bhartia1Matthew E J Callister2Paul Beirne3Neil Hancock4Philip A J Crosbie5Suzanne Rogerson6Rhian Gabe7Bethany Shinkins8Irene Simmonds9Alison Boland10Claire Eckert11Claire Bradley12Jason Lindop13Sara Upperton14Mike Darby15Tim J T Sutherland16Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UKDepartment of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK2 Leeds Institute of Health Sciences, University of Leeds, Leeds, UKRespiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK2 Leeds Institute of Health Sciences, University of Leeds, Leeds, UKDivision of Immunology, Immunity to Infection and Respiratory Medicine, The University of Manchester, Manchester, UK3 Department of Research and Innovation, Leeds Teaching Hospitals NHS Trust, Leeds, UK1 Wolfson Institute of Population Health, Queen Mary University, London, UKWarwick Screening & Warwick Evidence, Warwick Medical School, University of Warwick, Coventry, UK2 Leeds Institute of Health Sciences, University of Leeds, Leeds, UKLeeds Centre for Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, Leeds, UKLeeds Diagnosis and Screening Unit, University of Leeds, Leeds, UKNational Cancer Institute, National Institutes of Health, Bethesda, MD, USA3 Department of Research and Innovation, Leeds Teaching Hospitals NHS Trust, Leeds, UKDepartment of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UKDepartment of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UKDepartment of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UKIntroduction Interstitial lung abnormalities (ILA) are relatively common incidental findings in participants undergoing low-dose CT screening for lung cancer. Some ILA are transient and inconsequential, but others represent interstitial lung disease (ILD). Lung cancer screening therefore offers the opportunity of earlier diagnosis and treatment of ILD for some screening participants.Methods The prevalence of ILA in participants in the baseline screening round of the Yorkshire Lung Screening Trial is reported, along with the proportion referred to a regional ILD service, eventual diagnoses, outcomes and treatments.Results Of 6650 participants undergoing screening, ILA were reported in 169 (2.5%) participants. Following review in a screening review meeting, 56 participants were referred to the ILD service for further evaluation (0.8% of all screening participants). 2 participants declined referral, 1 is currently awaiting review and the remaining 53 were confirmed as having ILD. Eventual diagnoses were idiopathic pulmonary fibrosis (n=14), respiratory bronchiolitis ILD (n=4), chronic hypersensitivity pneumonitis (n=2), connective tissue disease/rheumatoid arthritis-related ILD (n=4), asbestosis (n=1), idiopathic non-specific interstitial pneumonia (n=1), sarcoidosis (n=1) and pleuroparenchymal fibroelastosis (n=1). Twenty five patients had unclassifiable idiopathic interstitial pneumonia. Overall, 10 people received pharmacotherapy (7 antifibrotics and 3 prednisolone) representing 18% of those referred to the ILD service and 0.15% of those undergoing screening. 32 people remain under surveillance in the ILD service, some of whom may require treatment in future.Discussion Lung cancer screening detects clinically significant cases of ILD allowing early commencement of disease-modifying treatment in a proportion of participants. This is the largest screening cohort to report eventual diagnoses and treatments and provides an estimate of the level of clinical activity to be expected by ILD services as lung cancer screening is implemented. Further research is needed to clarify the optimal management of screen-detected ILD.Trial registration number ISRCTN42704678.https://bmjopenrespres.bmj.com/content/10/1/e001490.full |
| spellingShingle | Martyn P T Kennedy Bobby Bhartia Matthew E J Callister Paul Beirne Neil Hancock Philip A J Crosbie Suzanne Rogerson Rhian Gabe Bethany Shinkins Irene Simmonds Alison Boland Claire Eckert Claire Bradley Jason Lindop Sara Upperton Mike Darby Tim J T Sutherland Diagnoses and treatments for participants with interstitial lung abnormalities detected in the Yorkshire Lung Screening Trial BMJ Open Respiratory Research |
| title | Diagnoses and treatments for participants with interstitial lung abnormalities detected in the Yorkshire Lung Screening Trial |
| title_full | Diagnoses and treatments for participants with interstitial lung abnormalities detected in the Yorkshire Lung Screening Trial |
| title_fullStr | Diagnoses and treatments for participants with interstitial lung abnormalities detected in the Yorkshire Lung Screening Trial |
| title_full_unstemmed | Diagnoses and treatments for participants with interstitial lung abnormalities detected in the Yorkshire Lung Screening Trial |
| title_short | Diagnoses and treatments for participants with interstitial lung abnormalities detected in the Yorkshire Lung Screening Trial |
| title_sort | diagnoses and treatments for participants with interstitial lung abnormalities detected in the yorkshire lung screening trial |
| url | https://bmjopenrespres.bmj.com/content/10/1/e001490.full |
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