Chronic Obstructive Pulmonary Disease Detection During Lung Cancer Screening—Reply

In Reply: Dr Young and Ms Hopkins mention the controversy surrounding the merit of diagnosing mild COPD. However, there is evidence that early cessation of smoking in high-risk individuals prevents disease progression and that early intervention may improve COPD outcome, making early detection clinically relevant. Furthermore, the Forum of International Respiratory Societies¹ notes that “Hundreds of millions of people struggle each year for life and breath due to lung diseases, including tuberculosis, asthma, pneumonia, influenza, lung cancer and chronic obstructive pulmonary disorder, and more than 10 million die.” They recognize that “Although it will be the 3rd leading cause of death worldwide by 2020, COPD is frequently not diagnosed.”¹ Thus, the importance of early COPD diagnosis is widely acknowledged. Automated screening of high-risk individuals who undergo CT for other reasons may play an important role in achieving this; the results of our study have shown that lung cancer screening CT scans may additionally be used to detect mild and previously unknown COPD cases with reasonable diagnostic accuracy.