Incidence of Lung Cancer in COPD Patients in Western Yokohama Managed by Primary Care Physicians with Hospital Collaboration

Yoshihiro Nishi,1,2 Takahiro Tsuburai,1,2 Yuko Komase,1 Kunihiro Yagihashi,3 Makoto Nishida,1,2 Shotaro Kaneko,1,2 Satoshi Tanaka,1,2 Hiromi Muraoka,1,2 Junko Ueno,1,2 Aya Matsushima,1,2 Yusuke Shinozaki,1,2 Kazuhiro Nishiyama,1,2 Yu Numata,1,2 Hajime Tsuruoka,1,2 Baku Oyama,1,2 Naoya Hida,1 Masamichi Mineshita,2 Takeo Inoue1 1Department of Respiratory Medicine, St. Marianna University Yokohama Seibu Hospital, Yokohama, Kanagawa, Japan; 2Department of Respiratory Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; 3Department of Radiology, St. Marianna University Yokohama Seibu Hospital, Yokohama, Kanagawa, JapanCorrespondence: Takahiro Tsuburai, Department of Respiratory Medicine, St. Marianna University Yokohama Seibu Hospital, Yasashi-chou 1197-1, Asahi, Yokohama, Kanagawa, 241-0811, Japan, Tel +81 45 366 1111, Fax +81 45 366 1190, Email [email protected]: Chronic obstructive pulmonary disease (COPD) is a common condition with respiratory obstructive impairment, and is often treated by primary care physicians. Because COPD is a high-risk factor for lung cancer, chest computed tomography (CT) is used to screen for early cancer detection. However, it is difficult for primary care physicians to conduct regular CT examinations. In the western Yokohama area, we have established a system of collaboration between primary care physicians and our hospital to manage COPD patients. We hypothesized that routine standard-dose CT examinations could detect lung cancer at early stage in COPD patients managed by primary care physicians via COPD coordinated system.Patients and Methods: From 114 COPD patients who visited Yokohama Seibu Hospital between January 2013 and March 2020 for the purpose of COPD consultation, we selected the 70 in whom either abnormal shadows had been detected or negative imaging findings confirmed on chest CT over a 5-year period.Results: Nodules were detected in 15 patients (21.4%) during the course of the study, with six of these founded to have lung cancer. Five of the six had were operable as early-stage cancer, and one had advanced small cell lung cancer and received chemotherapy. Detection of operable cases was difficult with chest X-rays.Conclusion: Routine chest CT may contribute to the early-stage detection of cancer in patients with COPD managed by primary care physicians in collaboration with hospitals.Keywords: chronic obstructive pulmonary disease, computed tomography, lung cancer, primary care