Lung Cancer in COPD Patients: Development and Validation of the COPD Lung Cancer Screening Score (COPD-LUCSS)

Background
Patients with chronic obstructive pulmonary disease (COPD) are at high-risk for lung cancer (LC) and represent a potential target to improve the diagnostic yield of screening programs.

Objective
Develop a predictive score for LC risk for patients with COPD.

Methods
The Pamplona-IELCAP LC screening study (P-IELCAP) and the Pittsburgh Lung Screening Study (PLuSS) databases were analyzed. Only patients with COPD on spirometry were included. By logistic regression we determined which factors were independently associated with LC in PLuSS and developed a COPD lung cancer screening score (COPD-LUCSS) to be validated in P-IELCAP.

Results
By regression analysis, age>60, BMI<25 kg/m2, pack-years history>60, and emphysema presence were independently associated with LC diagnosis and integrated into the COPD-LUCSS that ranges from 0 to 10 points.

Two COPD-LUCSS risk categories were proposed: low risk (scores 0-6) and high risk (scores 7-10). In comparison to low risk patients, in both cohorts LC risk increased 3.5 fold in the high-risk category.

Conclusions
The COPD-LUCSS is a good predictor of lung cancer risk in COPD patients participating in LC screening programs. Validation in two different populations adds strengths to the findings.

CITA DEL ARTÍCULO  Am J Respir Crit Care Med. 2014 Dec 18