2006 OPEN FORUM Abstracts
OUTCOME OF EARLY DETECTION AND PREVENTION OF LUNG CANCER AND CHRONIC OBSTRUCTIVE LUNG DISEASE: A PILOT STUDY
Anil Singh, MD, Peter
Kaplan, MD, Brian Carlin, MD, and Cathy MacConnell, RRT, RPFT, RPSGT,
Robert Keenan, MD, Anthony Lupetin, MD, and Jan Silverman, MD. Divisions of Pulmonary and Critical Care
Medicine, Cardiothoracic Surgery, Radiology, and Pathology, Allegheny General
Hospital, Pittsburgh, Pennsylvania.
Background: In view of the recent renewed interest in lung screening, we instituted a pilot program for detection of COPD and lung cancer in our hospital employees who were either current or former smokers. Our goals were to detect COPD and lung cancer, to enroll active smokers into a smoking cessation program, and to evaluate the outcome of the program.
Methods: Following informed consent, each subject completed a questionnaire (which included medical and smoking history), attended an orientation session to highlight the importance of early detection of COPD and lung cancer and underwent spirometric testing. Participants with airflow obstruction (based on GOLD criteria) underwent sputum cytology and chest CT scanning. Repeat CT scans were obtained if abnormalities were seen on the initial scan.
Results: There were 126 patients enrolled of which 16 were ineligible. Of the 110 participants, 76 had normal and 34 had abnormal spirometry. Thirty two of the 34 patients had CT scans. Seventeen scans were normal and 15 were abnormal. Of the 15 abnormal scans, 9 have been repeated to date. Sputum cytology was negative in 31 participants (3 did not complete). All results were communicated to the patient's primary care provider. Of the 32 participants with abnormal spirometry, 25 subsequently followed up with their primary care provider and seven with a pulmonologist. At the time of enrollment, 68 participants were active smokers and received counseling by the study coordinator at the time of enrollment and during each subsequent visit. To date, 17 have quit smoking.
Conclusions: Our pilot study demonstrated a high prevalence of abnormal lung function in current and former smoking hospital employees. A comprehensive communication and educational program resulted in excellent physician follow-up in impaired subjects and can be a means of enhancing early interventions in patients with COPD using the recently developed GOLD criteria.