Overview
- Among 9,047 asymptomatic adults with smoking history in I-ELCAP, 29.1% had emphysema on baseline low-dose CT, and nearly 80% of those cases had not been previously diagnosed.
- Hazard ratios showed emphysema independently predicted all-cause mortality (HR 1.29) and COPD mortality (HR 3.29), while the cardiovascular association (HR 1.14) did not remain significant after competing-risk analysis.
- Risk rose with emphysema severity for all-cause and COPD mortality, demonstrating a clear dose–response pattern not seen for cardiovascular deaths.
- By the end of 2024, 3,738 participants (41.3%) had died, most commonly from cardiovascular disease (12.7%) and COPD (3.3%), with median age at death around 81–82 years.
- Authors stress emphysema on LDCT is clinically meaningful and suggest using screening findings to guide preventive, multidisciplinary care, with some calling for reevaluating screening scope.