Evidence map›Paper›PMID 40935564›Full record

ArticleBMJ open respiratory research2025

Differentiating clinically important interstitial lung abnormalities in lung cancer screening.

Brintha Selvarajah, Amyn Bhamani, Mehran Azimbagirad, Burcu Ozaltin, Ryoko Egashira, Daisuke Yamada, John McCabe, Nicola Smallcombe, Priyam Verghese, Ruth Prendecki and 22 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open respiratory research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

32 authors.

Brintha Selvarajah *Centre for Inflammation and Tissue Repair, UCL Respiratory, University College London, London, UK.ORCID http://orcid.org/0000-0001-8342-9117
Amyn Bhamani *Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Mehran Azimbagirad *Satsuma Lab, Centre for Medical Image Computing, University College London, London, UK.
Burcu OzaltinSatsuma Lab, Centre for Medical Image Computing, University College London, London, UK.ORCID http://orcid.org/0009-0009-2426-2607
Ryoko EgashiraDepartment of Radiology, Faculty of Medicine, Saga University, Saga, Japan.
Daisuke YamadaSatsuma Lab, Centre for Medical Image Computing, University College London, London, UK.
John McCabeLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Nicola SmallcombeRoyal London Hospital, Barts Health NHS Trust, London, UK.
Priyam VergheseLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Ruth PrendeckiLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Andrew CreamerLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Jennifer L DicksonLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Carolyn HorstLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Sophie TisiLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Helen HallLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.ORCID http://orcid.org/0000-0001-7305-8367
Chuen R KhawLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Monica L MullinLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.ORCID http://orcid.org/0000-0002-0133-8826
Kylie GyertsonUniversity College London Hospitals NHS Foundation Trust, London, UK.
Anne-Marie HackerCancer Research UK and UCL Cancer Trials Centre, University College London, London, UK.
Laura FarrellyCancer Research UK and UCL Cancer Trials Centre, University College London, London, UK.
Anand DevarajRoyal Brompton and Harefield Hospitals, London, UK.
Arjun NairUniversity College London Hospitals NHS Foundation Trust, London, UK.
Mariia YunevaOncogenes and Tumour Metabolism Lab, The Francis Crick Institute, London, UK.
Neal NavaniUniversity College London Hospitals NHS Foundation Trust, London, UK.
Daniel C AlexanderUCL Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK.
Rachel Clare ChambersCentre for Inflammation and Tissue Repair, UCL Respiratory, University College London, London, UK.ORCID http://orcid.org/0000-0003-1370-9417
Joanna PorterCentre for Inflammation and Tissue Repair, UCL Respiratory, University College London, London, UK.
Allan HackshawCancer Research UK and UCL Cancer Trials Centre, University College London, London, UK.
Gisli JenkinsRoyal Brompton and Harefield Hospitals, London, UK.ORCID http://orcid.org/0000-0002-7929-2119
SUMMIT Consortium
Sam M Janes *University College London Hospitals NHS Foundation Trust, London, UK.
Joseph Jacob *Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK j.jacob@ucl.ac.uk.ORCID http://orcid.org/0000-0002-8054-2293

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundInterstitial lung abnormalities (ILAs) are common incidental findings in lung cancer screening (LCS). However, challenges remain in identifying clinically relevant ILAs as highlighted in a joint statement by a European multidisciplinary task force led by the European Respiratory Society (ERS). To address these challenges, we analysed ILAs identified in one of Europe's largest LCS studies.

methodsOf 11 635 LCS individuals, 417 screen-detected ILAs were evaluated using a new visual classification system focused on traction bronchiolectasis: non-fibrotic ILA (no traction bronchiolectasis), fibrotic ILA (traction bronchiolectasis in ≤2 lobes); undiagnosed interstitial lung disease (traction bronchiolectasis in >2 lobes). Observer agreement was compared with Fleischner Society ILA classification using Cohen's Kappa. An age, sex and smoking history-matched control group allowed the examination of associations between baseline ILA/UILD and comorbidities, forced vital capacity (FVC), hospitalisations (Student's t-tests) and mortality (univariable and multivariable Cox proportional hazards models).

findingsOur visual ILA classification showed superior interobserver agreement (K=0.76) versus the Fleischner ILA classification (K=0.64). ILA/UILD subjects had more prevalent comorbidities, increasing (vs controls) approximately 10 years prior to ILA/UILD diagnosis. Compared with controls, mortality rates were 6-fold higher for UILD participants and 3-fold higher for fibrotic and non-fibrotic ILA subtypes. On multivariable Cox regression analysis, ILA/UILD presence (HR=4.90, 95% CI =2.36 to 10.10, p<0.001) showed stronger independent associations with mortality than baseline FVC (HR=0.98, 95% CI =0.96 to 1.00, p=0.04).

conclusionWe demonstrate a new reproducible classification of clinically important ILA/UILDs in LCS populations. We highlight that FVC shows limited associations with mortality in ILA/UILD subjects. Increased multiorgan comorbidity in ILA/UILD subjects highlights a need for comprehensive early multisystem evaluation.

Indexed as

Early Detection of CancerLung Diseases, InterstitialLung NeoplasmsAgedComorbidityEuropeFemaleHumansIncidental FindingsLungMaleMiddle AgedObserver VariationVital CapacityIdiopathic Pulmonary FibrosisImaging/CT MRI etcInterstitial Fibrosis

Identifiers

PMID40935564
PMCPMC12506105

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.