Adding spirometry to lung cancer screening picks up undiagnosed COPD


By Emma Wilkinson

9 Jun 2020

Including spirometry as part of a lung cancer screening check for smokers is both feasible and likely to identify a significant number of patients with undiagnosed COPD, UK research suggests.

Analysis of data from the pilot of Lung Health Checks screening project in Manchester found that more than 99% of the 2525 smokers invited to participate successfully performed a spirometry test.

Airflow obstruction was found in 37.4% of those undergoing a lung health check and almost half of those (49.7%) had no previous diagnosis of COPD.

More than half (53.3%) of those without a previous diagnosis were symptomatic, the researchers reported in Thorax.

Overall it meant one in ten of those attending a Lung Health Check as part of the pilot scheme had symptoms and a previously unrecognised airflow obstruction raising the possibility of COPD, they concluded.

In the Manchester programme, current or past smokers aged 55-74 years were invited to attend screening in three deprived areas of the city, where they were asked about respiratory symptoms, had spirometry and were assessed with a risk score. Those at higher risk were invited for two rounds of annual low dose CT screening.

At the time of the pilot, the results of spirometry were sent as part of a report to the patient’s GP but since then a community respiratory service has been set up, explained study author Dr Phil Crosbie, Clinical Senior Lecturer and Honorary Consultant in Respiratory Medicine at the University of Manchester.

“We decided this shouldn’t just be about lung cancer, it should be holistic and the obvious thing to include was spirometry because its so quick. COPD is the 4th biggest killer in the world and its incredibly commonly undetected.”

“It worked very well and it was straightforward to include it.” He pointed out that while one reading is not a diagnosis it is an important indicator.

“A third had undetected airflow obstruction and a significant proportion of those had symptoms.”

The Manchester Lung Health check programme has since rolled out more widely and screened thousands more patients, added Dr Crosbie.

“NHS England has now said they want to do these lung health checks in 10 areas across the country. They’re all paused at the moment but I think across the patch they will be including spirometry.”

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