Patients who are eligible for lung cancer screenings (LCS) are also at risk for structural lung abnormalities, which can result in airflow obstruction and respiratory symptoms — including COPD.
A recent paper presented at the 2026 American Thoracic Society International Conference in Orlando, Florida, examined the rates of diagnosis and undertreatment of COPD in patients undergoing LCS who are part of the Temple University Health Chest Initiative.
The paper, “Underdiagnosis and Undertreatment of COPD in Individuals Undergoing Lung Cancer Screening in the Temple Healthy Chest Initiative,” was published in the American Journal of Respiratory and Critical Care Medicine.
Researchers examined data from 305 participants enrolled in initial LCS who consented to the study. They collected electronic medical record data and pre-bronchodilator spirometry from each participant and reviewed respiratory questionnaires, such as the COPD Airway Assessment Test (CAAT), and prior inhaler use to assess symptom burden.
The median age of those in the study was 63. Of the participants, 182 were female, 123 were male and 187 were active smokers. Most individuals (228) identified as Black/African American, and 158 had not been previously diagnosed with COPD.
Of those with no prior diagnosis, 49 had evidence of airflow obstruction and 153 had symptoms including mucus, cough and breathlessness. Of the total cohort, 48 of the participants with no prior diagnosis had airflow obstruction and a positive CAAT score. Thirty of those participants (62%) were not previously prescribed any inhaler therapy. Black/African American patients represented 43 of the undiagnosed cases, which suggests underserved populations are at risk of underdiagnosis and undertreatment.
The study’s lead author, Stephen Dachert, MD, assistant professor of clinical thoracic medicine at the Lewis Katz School of Medicine at Temple University, in Philadelphia, said in an interview with Medscape Medical News that the study showed high rates of undiagnosed COPD, high symptom burden and undertreatment — specifically in minority populations undergoing LCS.
“While prior studies have suggested underdiagnosis in lung cancer screening populations, the magnitude seen in this predominantly minority cohort reinforces how common missed opportunities for diagnosis remain in clinical practice,” he said.
