High prevalence of interstitial lung abnormalities in middle-aged never-smokers

Ida Pesonen, Fredrik Johansson, Åse Johnsson, Anders Blomberg, Marianne Boijsen, John Brandberg, Kerstin Cederlund, Arne Egesten, Össur Ingi Emilsson, Jan E. Engvall, Andreas Frølich, Emil Hagström, Eva Lindberg, Andrei Malinovschi, Nikolai Stenfors, Eva Swahn, Hanan Tanash, Raquel Themudo, Kjell Torén, Lowie E.G.W. VanfleterenPer Wollmer, Suneela Zaigham, Carl Johan Östgren, C. Magnus Sköld

Research output: Contribution to journalArticlepeer-review

Abstract

Background Interstitial lung abnormalities (ILA) are incidental findings on chest computed tomography (CT). These patterns can present at an early stage of fibrotic lung disease. Our aim was to estimate the prevalence of ILA in the Swedish population, in particular in never-smokers, and find out its association with demographics, comorbidities and symptoms. Methods Participants were recruited to the Swedish CArdioPulmonary BioImage Study (SCAPIS), a population-based survey including men and women aged 50–64 years performed at six university hospitals in Sweden. CT scan, spirometry and questionnaires were performed. ILA were defined as cysts, ground-glass opacities, reticular abnormality, bronchiectasis and honeycombing. Findings Out of 29 521 participants, 14 487 were never-smokers and 14 380 were men. In the whole population, 2870 (9.7%) had ILA of which 134 (0.5%) were fibrotic. In never-smokers, the prevalence was 7.9% of which 0.3% were fibrotic. In the whole population, age, smoking history, chronic bronchitis, cancer, coronary artery calcium score and high-sensitive C-reactive protein were associated with ILA. Both ILA and fibrotic ILA were associated with restrictive spirometric pattern and impaired diffusing capacity of the lung for carbon monoxide. However, individuals with ILA did not report more symptoms compared with individuals without ILA. Interpretation ILA are common in a middle-aged Swedish population including never-smokers. ILA may be at risk of being underdiagnosed among never-smokers since they are not a target for screening.

Original languageEnglish
Article number00035-2023
JournalERJ open research
Volume9
Issue number5
DOIs
Publication statusPublished - 2023 Sept

Subject classification (UKÄ)

  • Respiratory Medicine and Allergy

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