Introduction Incorporating spirometry into low-dose CT (LDCT) screening for lung cancer may help identify people with undiagnosed chronic obstructive pulmonary disease (COPD), although the downstream impacts are not well described. Methods Participants attending a Lung Health Check (LHC) as part of the Yorkshire Lung Screening Trial were offered spirometry alongside LDCT screening. Results were communicated to the general practitioner (GP), and those with unexplained symptomatic airflow obstruction (AO) fulfilling agreed criteria were referred to the Leeds Community Respiratory Team (CRT) for assessment and treatment. Primary care records were reviewed to determine changes to diagnostic coding and pharmacotherapy. Results Of 2391 LHC participants undergoing prebronchodilator spirometry, 201 (8.4%) fulfilled the CRT referral criteria of which 151 were invited for further assessment. Ninety seven participants were subsequently reviewed by the CRT, 46 declined assessment and 8 had already been seen by their GP at the time of CRT contact. Overall 70 participants had postbronchodilator spirometry checked, of whom 20 (29%) did not have AO. Considering the whole cohort referred to the CRT (but excluding those without AO postbronchodilation), 59 had a new GP COPD code, 56 commenced new pharmacotherapy and 5 were underwent pulmonary rehabilitation (comprising 2.5%, 2.3% and 0.2% of the 2391 participants undergoing LHC spirometry). Conclusions Delivering spirometry alongside lung cancer screening may facilitate earlier diagnosis of COPD. However, this study highlights the importance of confirming AO by postbronchodilator spirometry prior to diagnosing and treating patients with COPD and illustrates some downstream challenges in acting on spirometry collected during an LHC. All data relevant to the current manuscript are included in the article. The data sharing policy from the Yorkshire Lung Screening Trial itself are shown below. The Yorkshire Lung Screening Trial is a Clinical Trial ([ISRCTN42704678][1]). Data collected as part of this study are available on reasonable request according to the following data sharing policy. 'The YLST study is registered at the ISRCTN registry with identifier [ISRCTN42704678][1]. In order to meet our ethical obligation to responsibly share data generated by clinical trials, YLST operates a transparent data-sharing request process. Anonymous data will be available for request once the study has published the final proposed analyses. Researchers wishing to use the data will need to complete a request for data-sharing form describing a methodologically sound proposal. The form will need to include the objectives, what data are requested, timelines for use, intellectual property and publication rights, data release definition in the contract and participant informed consent, etc. A data-sharing agreement from the sponsor may be required'. The data presented here are mostly clinical data subsequent to trial participation, and so is not included in the above data sharing policy. [1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN42704678

中文翻译：

---

在肺部健康检查计划中，使用支气管扩张剂前肺活量测定与肺癌筛查一起进行的诊断和治疗结果

简介 将肺活量测定法纳入肺癌低剂量 CT (LDCT) 筛查可能有助于识别患有未确诊的慢性阻塞性肺病 (COPD) 的患者，尽管下游影响尚未得到很好的描述。方法 作为约克郡肺部筛查试验的一部分，参加肺部健康检查 (LHC) 的参与者在 LDCT 筛查的同时接受了肺活量测定。结果被传达给全科医生（GP），那些患有不明原因气流阻塞（AO）症状且符合商定标准的患者被转介给利兹社区呼吸小组（CRT）进行评估和治疗。审查初级保健记录以确定诊断编码和药物治疗的变化。结果 2391 名 LHC 参与者接受支气管扩张前肺活量测定，其中 201 名 (8. 4%）符合 CRT 转介标准，其中 151 人被邀请进行进一步评估。随后，97 名参与者接受了 CRT 的审查，46 名参与者拒绝了评估，8 名参与者在联系 CRT 时已经接受了全科医生的检查。总共 70 名参与者接受了支气管扩张剂后肺活量测定，其中 20 名 (29%) 没有 AO。考虑到整个队列均接受了 CRT（但不包括那些未进行 AO 支气管扩张后的患者），59 人有新的 GP COPD 代码，56 人开始新的药物治疗，5 人接受了肺康复（占 2391 名接受过肺康复治疗的参与者的 2.5%、2.3% 和 0.2%）。 LHC 肺活量测定法）。结论 在肺癌筛查的同时进行肺活量测定可能有助于 COPD 的早期诊断。然而，这项研究强调了在诊断和治疗 COPD 患者之前通过支气管扩张后肺量测定法确认 AO 的重要性，并说明了在大型强子对撞机期间收集的肺量测定法中采取行动的一些下游挑战。与当前手稿相关的所有数据都包含在文章中。约克郡肺部筛查试验本身的数据共享政策如下所示。约克郡肺部筛查试验是一项临床试验 ([ISRCTN42704678][1])。作为本研究的一部分收集的数据可根据以下数据共享政策应合理请求提供。“YLST 研究已在 ISRCTN 注册表中注册，标识符为 [ISRCTN42704678][1]。为了履行我们负责任地共享临床试验生成的数据的道德义务，YLST 运行透明的数据共享请求流程。一旦研究发布了最终的拟议分析，即可索取匿名数据。希望使用这些数据的研究人员需要填写数据共享表格请求，描述方法上合理的提案。该表格需要包括目标、请求哪些数据、使用时间表、知识产权和出版权、合同中的数据发布定义和参与者知情同意等。可能需要申办者的数据共享协议。这里提供的数据主要是参与试验后的临床数据，因此不包含在上述数据共享政策中。[1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN42704678 希望使用这些数据的研究人员需要填写数据共享表格请求，描述方法上合理的提案。该表格需要包括目标、请求哪些数据、使用时间表、知识产权和出版权、合同中的数据发布定义和参与者知情同意等。可能需要申办者的数据共享协议。这里提供的数据主要是参与试验后的临床数据，因此不包含在上述数据共享政策中。[1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN42704678 希望使用这些数据的研究人员需要填写数据共享表格请求，描述方法上合理的提案。该表格需要包括目标、请求哪些数据、使用时间表、知识产权和出版权、合同中的数据发布定义和参与者知情同意等。可能需要申办者的数据共享协议。这里提供的数据主要是参与试验后的临床数据，因此不包含在上述数据共享政策中。[1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN42704678 合同中的数据发布定义和参与者知情同意等。可能需要申办者的数据共享协议”。这里提供的数据主要是参与试验后的临床数据，因此不包含在上述数据共享政策中。[1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN42704678 合同中的数据发布定义和参与者知情同意等。可能需要申办者的数据共享协议”。这里提供的数据主要是参与试验后的临床数据，因此不包含在上述数据共享政策中。[1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN42704678