Incidental findings on chest X-ray or CT scans of COPD or emphysema

ncidental findings on chest X-rays or CT scans

• primary care respiratory review and spirometry should be considered for people with emphysema or signs of chronic airways disease on a chest X-ray or CT scan
  
  
• if the person is a current smoker, their spirometry results are normal and they have no symptoms or signs of respiratory disease:
  • offer smoking cessation advice and treatment, and referral to specialist stop smoking services
  • warn them that they are at higher risk of lung disease
  • advise them to return if they develop respiratory symptoms
  • be aware that the presence of emphysema on a CT scan is an independent risk factor for lung cancer
    
    
• if the person is not a current smoker, their spirometry is normal and they have no symptoms or signs of respiratory disease:
  • ask them if they have a personal or family history of lung or liver disease and consider alternative diagnoses, such as alpha-1 antitrypsin deficiency
  • reassure them that their emphysema or chronic airways disease is unlikely to get worse
  • advise them to return if they develop respiratory symptoms
  • be aware that the presence of emphysema on a CT scan is an independent risk factor for lung cancer

Reference:

• (1) Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2018. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease.
• (2) National Institute for Health and Clinical Excellence (NICE) 2010. Chronic obstructive pulmonary disease: Management of chronic obstructive pulmonary disease in adults in primary and secondary care