Incidental findings arising from targeted lung health checks: a GP practice perspective

ABSTRACT

Introduction: Newcastle Gateshead is a phase one Targeted Lung Health Checks site. Walker Medical Group GP practice serves a deprived population and is a designated Deep End practice. We report on the experience of Targeted Lung Health Checks at this practice. Method(s) Invitations were sent to eligible participants registered at the practice. Lung health checks were carried out by telephone according to Standard Protocol in the context of the COVID 19 pandemic. Those meeting criteria for Low Dose CT were invited to a mobile scanner located in the community near to the practice. Scans were reported according to the Standard Protocol. Result(s) Of 1481 eligible patients, 736 (50.44%) attended a telephone lung health check. 458 (63.6%) met criteria for a CT scan, of whom 33 declined a scan and 2 were unable to lie flat. 11 lung cancers (2.6%) and one other cancer were diagnosed. 71 (16.8%) had nodules requiring follow-up. These cases were managed by the TLHC programme and lung cancer MDT. Incidental findings had the greatest impact on general practice. 72.3% of scans showed coronary artery calcification. Of these, over 1 in 4 was not currently prescribed a Statin. New diagnoses of bronchiectasis (8 patients = 2%) and interstitial lung disease (7 patients = 1.6%) required GP action. 5 new cases of undiagnosed thoracic aortic aneurysm were identified, requiring referral for further action (1%). Conclusion(s) Incidental findings of Targeted Lung Health Checks CT scans require substantial input from a GP team. Coronary artery calcification is numerically most significant. Participants and practices should be supported by information and resources. Thoracic aortic aneurysm cases are also found in significant numbers and TLHC projects are advised to work with cardiology and cardiac surgery units when setting up. We plan to explore the reasons for participant refusal of CT scanning. Disclosure No significant relationships.Copyright © 2023 Elsevier B.V.