Validation of the COPD Lung Cancer Screening Score in a Community Based Cohort of COPD Patients
Introduction: Several scores have been developed to improve diagnostic yield of lung cancer screening programs. De-Torres et al presented a predictive lung cancer screening score (COPD-LUCSS) for patients with Chronic Obstructive Pulmonary Disease (COPD) (1). There is limited knowledge on the prognostic value of the score in COPD population at large.
Aims and objectives: To validate the COPD-LUCSS in a community based cohort of COPD patients and compare it to the National Lung Screening Trial (NLST) criteria for lung cancer screening (1).
Methods: COPD cases with CT thorax from a Norwegian community based study were merged with the Norwegian Cancer Register (n=422). The patients were divided into groups of high and low risk both according to the COPD-LUCSS and the NLST criteria. Cox regression was used to analyze associations between score methods and lung cancer, followed by Harrell's C to estimate predictive values.
Results: Based on COPD-LUCSS the high-risk group had a 2.9 fold risk of lung cancer compared to low-risk group (p=0.01). Based on the NLST the high-risk group had a 2.0 fold risk (p=0.07). Harrell's C values showed better predictive abilities for the COPD-LUCSS than the NLST criteria, 0.62 vs 0.58.
Conclusion: The COPD-LUCSS appropriately predicts lung cancer in a community-based cohort of COPD patients. The identification of COPD patients at risk for lung cancer was better for the COPD-LUCSS than for the NLST. 1. Juan P. de-Torres et al. Lung Cancer in COPD patients: development and validation of the COPD LUng Cancer Screening Score (COPD-LUCSS). AJRCCM Articles in Press. Published on 18-December-2014 as 10.1164/rccm.201407-1210OC.