Prevalence of bronchiectasis in a lung cancer screnning program

Introduction: Bronchiectasis has been classified as a comorbidity of COPD patients, associated with frequent exacerbations and severity of airflow limitation. In our study, we investigated the prevalence and characteristics of bronchiectasis in the lung cancer screening (LCS) program. Material and methods: A transversal study was performed. From 2014 until September 2018, 1005 patients were included in our LSC program. Of these, 949 had low-dose computed tomography (LDCT). The subjects met the NLST criteria (age between 55 and 75 who have a 30 pack-year smoking history and are currently smoking or have quit within the past 15 years) and had an additional risk factor of pulmonary emphysema and/or CODP. Other variables collected were clinical features, microbiological isolation, blood tests, and previous exacerbations. Statistical analyses were performed using SPSS version 22.0. Results: The prevalence of bronchiectasis was 11.3% (n = 107), mostly cylindrical (39.2%) and unilateral (57.9%). As expected based on inclusion criteria, 76.6% had emphysema on LDCT, and 48.6% had COPD. Most patients denied chronic sputum production (57.9%). Only 3 patients had evidence of colonization by Pseudomonas aeruginosa. Most patients (>90%) had < 1 exacerbation/year, and only 3.7% required hospitalization. C-reactive protein and fibrinogen were elevated in these patients, but the difference was not statistically significant. The prevalence of cancer in patients with bronchiectasis was 7.4% (n = 8), including 5 lung adenocarcinomas. Conclusions: Bronchiectasis are very prevalent in our lung cancer screening program and mostly asymptomatic. The prevalence of lung cancer in this population is higher than expected.