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Free Content Early detection of central airway lung cancer in smokers with silicosis

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BACKGROUND: Smokers with silicosis are at increased risk of lung cancer.

OBJECTIVE: To evaluate the feasibility of using autofluorescence bronchoscopy after sputum examination for early detection of large airway lung cancer and factors associated with the presence of cancerous and pre-cancerous lesions among smokers with silicosis.

METHODS: Subjects at the pneumoconiosis clinic were recruited if they fulfilled the following criteria: 1) age ≥40 years, 2) smoking history of ≥20 pack-years and 3) confirmed diagnosis of silicosis. Sputum specimens were collected for cytology/cytometry examination and autofluorescence bronchoscopy was performed in subjects with an abnormal sputum result.

RESULTS: A total of 48 subjects were recruited during the study period. The mean age and smoking history were respectively 63 ± 10 years and 51 ± 30 pack-years. Intraepithelial lung cancers and pre-neoplastic lesions (squamous metaplasia or above) were detected in respectively 2 (4.2%) and 14 (29.2%) subjects. The proportions of current smokers (75.0% vs. 40.6%, P = 0.03) and asbestos exposure (37.5% vs. 9.4%, P = 0.04) were significantly higher in subjects with the above lesions compared with those without.

CONCLUSIONS: Sputum examination followed by autofluorescence bronchoscopy may be a useful way of identifying cancerous/pre-cancerous lesions among silicotic smokers. Current smoking and asbestos exposure were associated with these lesions.
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Keywords: autofluorescence bronchoscopy; early detection; lung cancer; silicosis

Document Type: Regular Paper

Affiliations: 1: Department of Respiratory Medicine, Centro Hospitalar Conde de São Januário, Macao SAR, China; and Department of Medicine, University of Hong Kong, Hong Kong SAR, China 2: Department of Medicine, University of Hong Kong, Hong Kong SAR, China; and Department of Respiratory Medicine, Daping Hospital, Third Military Medical University, Chong Qing, Sichuan, China 3: Department of Health, Hong Kong SAR, China 4: Department of Medicine, University of Hong Kong, Hong Kong SAR, China

Publication date: 2011-04-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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