Work

Case Finding for COPD in Nottingham and District (C FIND COPD). A Pilot Study of Uptake, Acceptability and Diagnostic Yield in a One-Stop Assessment Following Lung Cancer Screening

Year: 2026

Type: article

Abstract: Background: Several lung cancer screening (LCS) programmes have identified a high prevalence of people with new (often pre-bronchodilator) airflow obstruction, but demonstrable translation into confirmed chronic obstructive pulmonary disease (COPD) diagnosis is limited. We evaluated a community-based, one-stop, post-bronchodilator case-finding and initial management pathway following LCS. Methods: Participants undergoing low-dose computed tomography (LDCT) as part of a LCS programme who reported respiratory symptoms were invited to attend a community-based assessment. The pathway included post-bronchodilator spirometry, clinical review and initial management delivered within a single encounter. The primary outcomes were uptake and new clinical diagnosis of COPD. Secondary outcomes included symptom burden, relationship to CT findings, socioeconomic variation and participant-reported experience. Results: Of 2860 invitation letters issues, 529 (18.5%) invitees participated; a further 33 participants self-presented. Of 562 participants overall, 486 completed spirometry, including 407 without a prior COPD diagnosis. Of these, 100 (25%) participants received a new clinical diagnosis of COPD, mainly with mild-to-moderate airflow obstruction. Among participants with a COPD Assessment Test (CAT) score ≥10, Medical Research Council (MRC) dyspnoea score ≥2, or clinician-defined respiratory symptoms, 35%, 34%, and 38%, respectively, had airflow obstruction. Moderate-to-severe CT emphysema was highly specific but poorly sensitive for airflow obstruction. We detected no significant difference in new COPD diagnosis across deprivation quintiles. Participant-reported experience was very positive. Conclusion: A community-based, one-stop pathway following LCS can identify clinically meaningful COPD diagnosis in symptomatic individuals. This single encounter approach addresses a key gap in current LCS-linked pathways, maximising opportunities for case finding and supporting accessible, patient-centred diagnostic services.

Source: International Journal of COPD

DOI: 10.2147/copd.s634297