In a lung cancer screening cohort, Black/African American participants had the lowest median FEV1% predicted (70%; P=0.012) and Caucasian participants had the highest blood eosinophil counts.
Observational (n=305)
How do race, gender, and smoking status affect airflow obstruction, respiratory symptoms, and Th2 inflammation in individuals undergoing lung cancer screening?
In a lung cancer screening cohort, significant differences in Th2 inflammation markers, airflow obstruction, and respiratory symptoms were observed across different racial and ethnic groups.
Abstract Rationale Patients eligible for lung cancer screening (LCS) are at risk for structural lung abnormalities resulting in airflow obstruction and respiratory symptoms. Th2 inflammation is linked to airway wall thickening and remodeling in patients with COPD, however the role of Th2 inflammation in patients undergoing LCS is uncertain. Herein, we describe the effects of race, gender and smoking status on spirometry parameters, respiratory symptoms, blood eosinophil counts (BEC) and fractional excretion of nitric oxide (FeNO) 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 along with BEC and FeNO performed at time of first study visit. Mann Whitney-U test and Kruskal-Walace tests performed for continuous variables compared against sex and smoking status and race, respectively. 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 interquartile rage (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. Median (IQR) BEC were 130 (150) and 145 cells/uL (162) for females and males respectively (p = 0.09). Median (IQR) Chronic Airways Assessment Test (CAAT) scores were 20 (13) and 19 (13) for females and males respectively (p = 0.07). Median (IQR) BEC were 180 (200), 125 (158), 205 cells/uL (200) for non-Caucasian Hispanic, Black/African American and Caucasian/White participants respectively (p = 0.014) Median (IQR) FEV1%Pred was 76 (24.5), 70 (27.8), 74.5 (32.8) for non-Caucasian Hispanic, Black/African American and Caucasian/White participants, respectively (p = 0.012). Median (IQR) CAAT scores were 24 (13), 19 (12), 16.5 (18) for non-Caucasian Hispanic, Black/African American and Caucasian/White participants, p = 0.001). Median (IQR) FeNO was 8 (10) and 13.5 (11) in current and former smokers, respectively p 0.001). Median (IQR) CAAT: Mucus score was 2(4) and 1.5 (3) in current and former smokers respectively p = 0.009. Conclusion Results from the Temple Healthy Chest Initiative LCS cohort showed higher levels of BEC in males compared to females, and in white/Caucasian and Hispanic individuals compared to black/African American individuals. Lowest FEV1 was found in in Black/African American participants. Non-Caucasian Hispanic individuals were the most symptomatic by CAAT scores followed by Black/ African American and White/Caucasian participants. This abstract is funded by: AstraZeneca
Dachert et al. (Fri,) conducted a observational in Lung cancer screening (n=305). In a lung cancer screening cohort, Black/African American participants had the lowest median FEV1% predicted (70%; P=0.012) and Caucasian participants had the highest blood eosinophil counts.