Introduction: The prevalence of respiratory symptoms (RS) and respiratory diseases (RD) are higher among tobacco smokers.

Aims and objectives: To determine the prevalence of self-reported RS and RD among lung cancer (LC) screening subjects and to compare differences by scoring results.

Methods: Subjects aged 50-74 with a smoking history of 30 pack-years or more and/or 20 pack-years with additional risks underwent low-dose CT evaluation. Radiological assessment and further evaluation were done per the Lung RADS score. Self-report data on RD and symptoms in the past 6 months were compared to Lung RADS score results.

Results: From September 2020 to December 2022, 2138 subjects were included in the LC screening program in North Serbia.

Prevalence of Lung RADS scores 0, 1, 2, 3, 4A, 4B and 4X were respectively 0.2%, 43.8%, 38.7%, 8.0%, 6.1%, 0.7% and 2.4%.

Prevalence of recurrent pneumonia, asthma, chronic bronchitis and COPD was 9.7 %, 6.7%, 6.7% and 5.4%, respectively. Chronic bronchitis prevalence was significantly different by screening score and was highest in 4X (22.4% vs. 6.6%, p<0.001).

Prevalence of dyspnea, fatigue, cough, wheezing, chest pain, weight and appetite loss were respectively 32.8%, 31.5%, 25.8%, 23.8%, 6.4%, 8.4% and 6.4%.

Wheezing (36.7% vs. 23.2%, p=0.02), appetite (18.4% vs. 6.1%, p=0.001) and weight loss (22.4% vs. 7.8%, p<0.001) were significantly different by screening score and were highest in 4X. Subjects with chronic bronchitis had a higher risk of 4X score than patients without the disease (OR=3.3, 95% CI=1.61-6.84, p=0.001).

Conclusion:

Chronic bronchitis, long-term wheezing, appetite and weight loss were more common among subjects with positive scores.