FEV1 and Dlco as Additional Risk Stratifying Parameters in Lung Screening Programs

SESSION TITLE: Lung Cancer SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: Reduced FEV1% and DLCO are risk factors for lung cancer independent of smoking history and may help identify patients who could benefit from CT lung screening. METHODS: We performed a retrospective study of all individuals who had undergone both CT lung screening and pulmonary function testing (PFT) at our institution from January 2012 to December 2016. All patients met the National Comprehensive Cancer Network Lung Cancer Guidelines high-risk criteria. Each patient had at least one pulmonary function test (PFT) prior to or after the baseline CT lung screening exam. Categorical variables were analyzed using the Fisher’s exact test. Nonparametric variables were analyzed using Wilcoxon rank sum test. Logistic regression was used to assess the association of FEV1% and DLCO with a lung cancer diagnosis. A p-value ≤ 0.05 was deemed as statistically significant. RESULTS: 1231/3240 (38%) of patients underwent CT lung screening and PFTs during the study interval. 61/1231 (5%) of patients were diagnosed with lung cancer. Predicted median FEV1% was significantly different between cancer and non-cancer (64% vs 73%, p-value = 0.0091). Logistic regression showed decreasing FEV1 by 10% will increase the chances of having cancer by 16.3% (odds=1.163; 95%CI: 1.031-1.315; p=0.0163). Also decreasing DLCO by 10% will increase the chances of having cancer by 12.8% (odds=1.128; 95%CI: 0.970-1.301; p=0.1141). Patients who had FEV1<66% have 2.4 times higher chances to get cancer than patients who had FEV1≥66% (odds=2.431; 95%CI: 1.443-4.094; p=0.0008). CONCLUSIONS: Impaired FEV1% and DLCO are additional parameters associated with an increased risk of malignancy. CLINICAL IMPLICATIONS: FEV1% and DLCO may be additional variables that could be incorporated in the existing inclusion criteria for lung cancer screening. DISCLOSURE: The following authors have nothing to disclose: Tulip Jhaveri, Van Le, Ahmed Agameya, Yuxiu Lei, Amanda Jimenez, Anthony Campagna, Shawn Regis, Brady McKee, Carla Lamb No Product/Research Disclosure Information