CHEST 2011: Embargoed studies highlight new lung cancer and COPD research

(Press-News.org) Detroit Holds Record for Highest Lung Cancer Mortality Rates
(#1111771, Tuesday, October 25, 3:00 PM Eastern) Compared with other cities, Detroit has one of the highest mortality rates in the United States for non-small cell lung cancer (NSCLC). Based on data from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program, researchers from the McLaren Regional Medical Center in Flint, Michigan and the Mayo Clinic, in Minneapolis, Minnesota studied cancer-specific survival between Detroit and other city registries by ethnicity. They identified a total of 105,522 cases of small cell lung cancer and 3,094,764 cases of NSCLC. In all categories among ethnicities, Detroit showed lower survival rates than anywhere else in the United States. The differences in mortality existing between registries could reflect differences in health-care access and the stage of the tumor at the time discovered.

Conflicting Standards May Lead to Overdiagnosis or Underdiagnosis of COPD
(#1118428, Sunday, October 23, 4:45 PM Eastern) Researchers from The Brooklyn Hospital Center in New York documented the diagnosis, stratification, and treatment discordance between the most widely accepted Global Initiative for Chronic Obstructive Lung Disease (GOLD) standards and the American Thoracic Society/European Respiratory Society (ATS/ERS) standards for COPD. After reviewing the pulmonary function reports of 217 patients with the clinical diagnosis of COPD, researchers found the rate of discordance was 11%, while four patients with a median age of 41 years met the ATS standards but not the GOLD standards. The conflicting diagnostic criteria, severity classification, and treatment recommendations create a dilemma in patient care, especially in patients with borderline diagnostic criteria and overlapping classifications of severity. Without this consensus, older patients may be overdiagnosed with COPD and younger patients underdiagnosed with COPD.

Canadian Patients With COPD Exacerbations More Likely to Delay Medical Attention
(#1104875, Tuesday, October 25, 3:00 PM Eastern) COPD is identified as the leading cause of preventable hospitalizations in Canada. To understand how Canadian patients, physicians, and researchers perceive COPD compared with those in other nations, researchers from the Asthma and Airway Centre, University Health Network, and Family Physician Airways Group of Canada in Toronto surveyed 2,000 people from an international random sample of patients with COPD, primary care physicians, and respiratory specialists recruited from 14 nations. Of the Canadian patients (mean age, 62 years), 59% reported having at least one COPD exacerbation, while the overall percentage of patients reporting exacerbations was 69%. However, while 73% of international respondents would seek professional expertise during an exacerbation, only 55% of Canadians would do so. Although 28% of patients in other countries would seek professional help after 2 days, only 20% of Canadians sought assistance during that time. The 8% of patients typically taking no action was greater than the global average of 5%. Researchers concluded that a focus on self-management plans may reduce COPD exacerbation consequences in Canada.

Patients With COPD Can Be Diagnosed Via Presurgical Screening
(#1106050, Wednesday, October 26, 3:00 PM Eastern) A recent study by Canadian researchers from Jewish General Hospital in Montreal, QC, Canada determined that, through a simple preoperative screening program, patients with previously undetected COPD may be diagnosed and appropriately managed. In a surgical preadmission clinic of a tertiary care university hospital in Montreal, current smokers and ex-smokers were questioned using the Canadian Health Lung Test to determine any respiratory symptoms. Between July 2010 and March 2011, 127 patients with a positive screening result were referred for spirometry, the standard diagnostic tool for COPD. Of the 43 patients with abnormal spirometry results, 22 patients (51%) represented newly found cases of COPD, 17 (40%) were known and confirmed cases, and 14 patients (82%) had at least moderate obstruction. Of the newly found cases of COPD, 14 patients (64%) had mild obstruction, which suggests that they were diagnosed at an earlier stage of the disease. Results suggest that preoperative screening may help identify patients with undiagnosed COPD, which may lead to earlier disease management and control of disease progression.

Proton Pump Inhibitors May Help Prevent Common Cold, COPD Exacerbations
(#1107813, Wednesday, October 26, 3:00 PM Eastern) To determine whether proton pump inhibitors (PPIs) reduce the frequency of the common cold and resulting exacerbations among patients with COPD, Japanese researchers studied 100 former smokers with COPD, half who had received usual COPD therapies and PPIs and half who received only standard care. Both groups were observed for 12 months, and the frequency during which they caught colds was assessed. The number of acute exacerbations per person in that year within the PPI group was significantly lower than the control group that did not use PPIs; however, there was no significant difference between the numbers of common colds per person in 1 year in the PPI group and control group. This study demonstrated the beneficial effects of adding PPIs to the usual therapies for preventing COPD exacerbations.

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