Assessing the impact of local lung cancer screening on our regional interstitial lung diseases service

Abstract

Introduction: Lung cancer screening (LCS) using computed tomography (CT) scans was introduced to identify lung cancers early, however can potentially identify other abnormalities including interstitial lung diseases (ILD) or abnormalities (ILA) similarly. Aims: We aim to investigate the impact our LCS programme has had on our regional ILD service. Methods: Data of patients identified with ILA was obtained from our local LCS database from July 2021 to November 2022. Electronic patient records were used to identify outcomes and impact after CT scans were done. CT scans were reported as having ‘5-10% ILA’ or ‘>10% ILA’. Results: 5927 patients had CT scans for LCS from July 2021 to November 2022, of which 64 (1%) were reported to have ILA. 37 (58%) of them had 5-10% ILA and 27 (42%) had >10% ILA. 17 (27%) were referred to the ILD service and another 7 (11%) to a General Respiratory clinic. No further respiratory referrals were made for 37 (58%) and the remaining 3 were already under our ILD service. Just one-tenth (4) of those with 5-10% ILA were referred to the ILD service, whereas half (13) of those with >10% ILA were referred to us and a further quarter (7) were referred to a General Respiratory clinic for further care. Conclusion: Lung cancer screening programmes are able to identify a small, but potentially significant number of patients with ILAs at an earlier stage, that may require input from ILD teams. We are working to formalize a pathway for onward referral of such patients with >10% ILA locally to allow for a standardised approach to their management and earlier treatment, as appropriate.