Respiratory Function Tests Necessary with Lung Cancer Screening

QUICK FACTS

• 15 122 new cases of lung cancer were diagnosed in 2024
• 638 100 or 2.5% of Australians have COPD increasing to 1/14 when aged >65 years
• 8 million or 11% of Australians have asthma
• 229 000 lung cancer screenings are estimated to be performed in 2025

A recently published Systematic Review and Meta-Analysis in CHEST (issue July 2025) highlights the prevalence crossover of COPD and airflow limitation conditions in patients with lung cancer. This includes two major studies within Australia along with many European nations and the Americas.

Importantly, 62.5% of those confirmed with an airflow limitation were not aware!

 THE DETAILS

Of the almost 200 000 participants that undertook lung cancer screening across the 42 studies, patients were also found to have;

• Emphysema prevalence of 45.3% and was significantly increased if;
  • Age >60yrs (OR 1.78)
  • >40 pack years of tobacco use (OR 1.71)
  • Male sex
  • Ethnicity (South America)
  • Of which, 28.8% had moderate to severe COPD
• Airflow limitation prevalence was 40.1% and was significantly increased if;
  • Age >60yrs
  • >40 pack years of tobacco use (OR 2.11)
  • Male sex
  • Ethnicity (South America)
  • Of which 44.4% and 9.9% were moderate and severe on the GOLD criteria respectively

KEY TAKEAWAYS

• Importance of checking in on your patients’ respiratory symptoms across the lifespan, but particularly when aged over 60 years.
• GP should ensure their patients are also screened with spirometry if undertaking suspected or routine lung cancer screening
• Early detection is critical to improve lung cancer survival rates
• COPD is associated with increased mortality and reduced quality of life, appropriate management is crucial

Links to studies and statistics:

1. DOI: 10.1016/j.chest.2025.02.021
2. https://www.abs.gov.au/statistics/health/health-conditions-and-risks/chronic-obstructive-pulmonary-disease/latest-release
3. https://www.canceraustralia.gov.au/cancer-types/lung-cancer/lung-cancer-australia-statistics
4. https://www.aihw.gov.au/reports/chronic-respiratory-conditions/asthma
5. https://www.health.gov.au/resources/publications/nlcsp-participation-modelling?language=en