Lung Cancer Screening Improves Time to Diagnosis of Interstitial Lung Disease (ILD)

Patients with interstitial lung disease (ILD) experience delays from onset of symptoms to diagnosis of 2.3 years on average (Wuyts, W.A. et al. Adv Ther 2020 37, 3246). Diagnostic delays lead to poorer outcomes and prevention of fibrosis is a priority. The targeted lung health check (TLHC) is a lung cancer screening pilot in the UK. Individuals aged 55-74 years with a smoking history are assessed and may be invited for CT chest. In 2023, 5110 TLHC CT scan were performed across southeast London and 39 were referred to the ILD service. <fig><object-id>erj;64/suppl_68/PA495/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> To date, 33 (87%) patients have been assessed. 26 patients were diagnosed with ILD (Figure 1), of which 11 were smoking related, and 14 reported minimal to no symptoms suggesting early disease. Of those assessed, 10 (30%) did not require further input and have been discharged from the ILD service, and 6 (18%) have been prescribed immunosuppressive or antifibrotic treatment. Mean time from CT to ILD diagnosis was 77 days (range 19-168 days, median 74 days). Lung cancer screening can reduce time to diagnosis of ILD, allow earlier introduction of disease modifying treatment, and help minimise irreversible pulmonary fibrosis. With 30% of referrals not requiring continuing ILD specialist input, refining TLHC referral criteria and multidisciplinary ILD review of scans prior to assessment could serve to further improve time to diagnosis and minimise the additional burden on local ILD services.