Factors influencing the decline in lung density in a Danish lung cancer screening cohort

Saher B. Shaker, Asger Dirksen, Pechin Chien Pau Lo, Lene Theil Skovgaard, Marleen de Bruijne, Jesper H. Pedersen

14 Citations (Scopus)

Abstract

Lung cancer screening trials provide an opportunity to study the natural history of emphysema by using computed tomography (CT) lung density as a surrogate parameter. In the Danish Lung Cancer Screening Trial, 2,052 participants were included. At screening rounds, smoking habits were recorded and spirometry was performed. CT lung density was measured as the volume-adjusted 15th percentile density (PD15). A mixed effects model was used with former smoking males with,30 pack-yrs and without airflow obstruction (AFO) at entry as a reference group. At study entry, 893 (44%) participants had AFO. For the reference group, PD15 was 72.6 g.L-1 with an annual decline of-0.33 g.L-1. Female sex and current smoking increased PD15 at baseline, 17.3 g.L-1 (p<0.001) and 10 g.L-1 (p<0.001), respectively; and both increased the annual decline in PD15 (female:-0.3 g.L-1; current smoking:-0.4 g.L-1). The presence and severity of AFO was a strong predictor of low PD15 at baseline (Global Initiative for Chronic Obstructive Lung Disease (GOLD) I:-1.4 g.L -1; GOLD II:-6.3 g.L-1; GOLD III:-17 g.L-1) and of increased annual decline in PD15 (GOLD I:-0.2 g.L-1; GOLD II:-0.5 g.L-1; GOLD III:-0.5 g.L-1). Female sex, active smoking and the presence of AFO are associated with accelerated decline in lung density.

Original languageEnglish
JournalEuropean Respiratory Journal
Volume40
Issue number5
Pages (from-to)1142-1148
Number of pages7
ISSN0903-1936
DOIs
Publication statusPublished - 1 Nov 2012

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