Incidental Emphysema on Health Screening Chest CT and All-Cause Mortality in a Korean Cohort.
Among ever-smokers, incidental emphysema on screening CT was associated with higher mortality
Incidental Emphysema on Health Screening Chest CT and All-Cause Mortality in a Korean Cohort.
Incidental emphysema on health-screening chest CT is common, yet its prognostic significance in asymptomatic populations is poorly characterized.
This retrospective cohort comprised 41,291 adults undergoing chest CT during routine Korean health checkups (2002-2019).
ever-smokers with emphysema had higher risk of death
Emphysema was present in 3,774 participants (9.1%), rising from 2.6% in never-smokers to 14.6% in current smokers; over a median of 8.5 years, 284 deaths occurred.
Full-cohort pack-years imputation was non-significant (1.36; 0.97-1.91), diluted by never-smokers, among whom no participant with emphysema died.
An exploratory cancer signal (HR, 2.25) was concentrated in lung cancer (13 events).
Adding emphysema to a smoking-inclusive model improved discrimination by ≤0.004.
Among ever-smokers, incidental emphysema on screening chest CT is associated with mortality after adjustment for pack-years, although residual smoking-intensity confounding cannot be excluded.
Once smoking history is known, the report adds almost nothing to discrimination and should not be used alone to stratify prognosis; whether it should prompt evaluation for undiagnosed COPD we did not address.