Abstract Rationale Patients eligible for lung cancer screening (LCS) are at risk for structural lung abnormalities resulting in airflow obstruction and respiratory symptoms. Previous LCS cohorts have demonstrated high rates of undiagnosed COPD. Herein, we describe rates of diagnosis and undertreatment of COPD based on spirometry parameters, and respiratory questionnaires, in patients undergoing LCS. Methods 305 participants enrolled in initial LCS consented to the study. Electronic medical record (EMR) data and pre-bronchodilator (pre-BD) spirometry were collected. Respiratory questionnaires were utilized to assess symptom burden via COPD Airway Assessment Test (CAAT) and prior inhaler use. Categorical variables compared via chi squared test. This work was supported by grants from AstraZeneca and the Temple Lung Center Results 305 participants enrolled in the LCS study had complete QCT data. Median age was 63 IQR 10, 182 females, 123 males, 187 active smokers. 42 participants self-identified as non-Caucasian Hispanic, 228 self-identified as Black/ African American, and 31 self-identified as White/Caucasian. 158 (52%) were not previously diagnosed with COPD. Of the 158 participants without a previous diagnosis of COPD, 49 (31.2%) had evidence of airflow obstruction and 153 (97%) had symptoms defined as CAAT 1 for any of mucus, cough, or breathlessness. Of the total 305 cohort, 48 (15.7%) participants without previous COPD diagnosis had airflow obstruction, positive CAAT score. GOLD classification of these participants was 6 (12.2%), 30 (61.2%), 10 (20.4%), 3 (6.1%) for GOLD 1-4, respectively. Of the 48 participants with undiagnosed COPD, 30 (62.5%) were not previously prescribed any inhaler therapy and 5 (10.4%) were previously prescribed SABA only therapy. 43 (18.4%), 6 (14.2%), 0 (0%) of Black/African American, Non-Caucasian Hispanic, and Caucasian/White participants had undiagnosed COPD (p = 0.03). Conclusion Results from the Temple Healthy Chest Initiative LCS cohort showed high rates of undiagnosed COPD, high symptom burden, and undertreatment, specifically in minority populations undergoing LCS. This abstract is funded by: AstraZeneca
Dachert et al. (Fri,) studied this question.