Male gender was associated with significantly higher median quantitative emphysema compared to females (2.45 vs 1.29 %LAA-950 HU, p=0.002), whereas females had greater airway wall thickness and ILA.
Observational (n=305)
Do race, gender, and smoking status affect quantitative CT parameters of emphysema, airway wall thickness, and interstitial lung abnormality in individuals undergoing lung cancer screening?
In a lung cancer screening cohort, quantitative CT revealed significant sex differences, with males having more emphysema and females having greater airway wall thickness and interstitial lung abnormalities.
Absolute Event Rate: 2.45% vs 1.29%
p-value: p=0.002
Abstract Rationale Patients eligible for lung cancer screening are at risk for structural lung abnormalities including emphysema and airway wall thickening and interstitial lung abnormality (ILA). ILA consists of subtle early or subclinical interstitial changes which have been linked to ILD development over time. Herein, we describe the effect of race, gender and smoking status on Quantitative CT evidence of emphysema and airway wall thickening and ILA. Methods 305 participants enrolled in initial LCS (THCI) consented to study. Electronic medical record (EMR) data and pre-bronchodilator (pre-BD) spirometry were collected along with CT imaging data (quantitative image analysis: AVIEW COPD, Coreline. Mann Whitney-U test and Kruskal-Walace tests were performed for continuous variables compared against sex and smoking status and race, respectively. This work was supported by grants from AstraZeneca and the Temple Lung Center. Results 305 participants enrolled in THCI LCS study had complete QCT data. Median age was 63 yrs. IQR 10, 182 females, 123 males, 187 active smokers. 42 individuals self-identified as non-Caucasian Hispanic, 228 self-identified as Black/ African American, and 31 self-identified as White/Caucasian. Median (IQR) %Emphysema as defined as %LAA-950 HU was 2.45 (4.54) and 1.29 (4.07) for males and females respectively (p = 0.002). %LAA-950 was 3.51 (5.97), 1.70 (4.67), and 1.18 (2.61) White/Caucasian, Black/ African American, and non-Caucasian Hispanic participants respectively (p = 0.102). %LAA-950 HU was 2.81 (6.03) and 1.47 (3.14) for former and current smokers, respectively (p = 0.002). Median airway wall thickness (AWT-Pi10) was 4.29 (1.15) and 3.73 (1.20 for females and males respectively (p 0.001). Median (AWT-Pi10) was 4.12 (0.95), 4.08 (1.36), 3.88 (1.12) for non-Caucasian Hispanic, Black/ African American and White/Caucasian individuals (p = 0.714). Median (AWT-Pi10) was 4.14 (1.38) and 4.06 (1.20) for former and current smokers, respectively (p = 0.786). Median %ILA was 0.99 (2.71) and 0.64 (1.37) in females and males, respectively (p = 0.005). Median % ILA was 0.88 (2.40), 0.80 (1.34), and 0.58 (0.877) for Black/African American, non-Caucasian Hispanic, and White/Caucasian participants, respectively (p = 0.175). Median % ILA was 0.810 (2.02) and 0.78 (1.91) for current and former smokers, respectively (p=.0665). Conclusion Results from the Temple Healthy Chest Initiative LCS cohort showed significantly higher rates of quantitative emphysema in males compared to females but higher airway wall thickness and ILA in females compared to males. Differences in quantitative emphysema and ILA across race and ethnicity trended toward significance. There was significantly less quantitative emphysema in the current smoking group compared to former smokers. This abstract is funded by: AstraZeneca
Dachert et al. (2026) conducted an observational in Lung cancer screening eligibility (n=305). Male gender was associated with significantly higher median quantitative emphysema compared to females (2.45 vs 1.29 %LAA-950 HU, p=0.002), whereas females had greater airway wall thickness and ILA.