What question did this study set out to answer?

This study aims to assess the relationship between blood eosinophil count and symptoms, exacerbation frequency, and disease severity in lung cancer screening patients.

May 20, 2026

A80-2-31 Association Between Blood Eosinophil Levels, Symptoms, and Exacerbations in a Lung Cancer Screening Cohort the Temple Healthy Chest Initiative

Key Points

This study aims to assess the relationship between blood eosinophil count and symptoms, exacerbation frequency, and disease severity in lung cancer screening patients.
Prospective cohort study involving 315 participants undergoing lung cancer screening in the THCI.
Data from electronic medical records, spirometry, and CT imaging were collected.
Eosinophil counts and symptom severity were analyzed using Chi-square and Mann-Whitney U tests.
No significant difference in exacerbations between those with ≥300 eosinophils (13%) vs. <300 eosinophils (10%) with p=0.52.
Comparison of patients with ≥150 eosinophils (10.1%) to <150 (10.9%) also showed no significance with p=0.82.
Symptom analysis indicated no significant differences in cough, mucus production, or breathlessness between eosinophil groups (all p>0.1).

Abstract

Abstract Rationale Blood eosinophil count (BEC) is increasingly recognized as a biomarker of airway inflammation and exacerbation risk in COPD, but its clinical relevance in screening populations remains uncertain. This study evaluated the association between BEC and symptoms, exacerbation frequency, and disease severity among individuals undergoing lung cancer screening in the Temple Healthy Chest Initiative (THCI). Methods In this prospective cohort study, 315 participants underwent lung cancer screening (LCS) in the THCI. EMR data, pre-bronchodilator spirometry, and CT imaging (AVIEW COPD, Coreline) were collected. Blood eosinophil count (BEC) and fractional exhaled nitric oxide (FeNO) were measured. Eosinophilia was evaluated using the Chi-square test, while exacerbation history and symptoms were analyzed with the Mann-Whitney U test. CAAT scores were compared using the Student’s t-test. Results Prospective data were obtained from 313 patients, 2 were missing exacerbation data. Among those with ≥300 eosinophils (n = 54) versus 300 eosinophils (n = 259), there was no significant difference in 1-year exacerbations (13% vs. 10%; χ²(1, N = 313)=0.41, p = 0.52). Similarly, no difference was observed when comparing patients with ≥150 eosinophils (n = 148) to those with 150 (10.1% vs. 10.9%; χ²(1, N = 313)=0.05, p = 0.82). Symptom analysis showed no significant differences in cough, mucus production, or breathlessness between eosinophil groups (≥300 vs. 300 or ≥ 150 vs. 150; all p 0.1). Mean CAAT scores were also comparable (≥300: 19.35±8.0 vs. 300: 19.46±8.7, p = 0.93; ≥150: 19.41±8.6 vs. 150: 19.47±8.7, p = 0.96). Conclusion BEC were not associated with exacerbation risk, symptom burden, or CAAT scores in this lung cancer screening cohort of the THCI. These findings suggest that BEC alone may have limited utility in predicting COPD symptoms or exacerbations in individuals identified through lung cancer screening, underscoring the need for additional markers of disease activity. This abstract is funded by: AztraZeneca and Temple Lung Center

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