Introduction:

Interstitial lung disease diagnosis (ILD) provides a clinical challenge due to delay in presentation. National lung cancer screening may offer an opportunity for ILD early diagnosis.

Aims and Purpose:

To determine the prevalence of interstitial lung abnormalities (ILA) and ILD in a cohort of current and former smoking patients, who underwent Lung Health Check (LHC) Computer tomography (CT) as part of a UK national lung cancer screening pilot study.

Methods:

This was a retrospective study of patients enrolled in a UK pilot lung cancer screening programme from March 2021 to Dec 2022 who were identified as having significant ILA or possible ILD referred for specialist respiratory assessment for ILD.

Results:

Of 8,800 patients, 7.4% had findings for equivocal ILA and assessed in screening MDT.  79 were deemed to have significant ILA, warranting further assessment, and 85% were given a diagnosis of ILD. The most common diagnosis was smoking related ILD followed by UIP pattern fibrosis. 

Symptomatic and asymptomatic patients had similar rates of diagnosis of ILD. Lack of symptoms does not support absence of disease and should not prevent investigation. Lung function was useful in distinguishing ILD from ILA, with impaired FVC and gas transfer.  40% of patients required regional ILD MDT input and 84% require ongoing local monitoring.

Conclusion:

Lung cancer screening offers an opportunity for early ILD diagnosis and early intervention, which may improve disease trajectory. Lung cancer screening will lead to increased referrals to local respiratory services and the specialist ILD MDT.