Undiagnosed COPD Common Among Lung Cancer Screening Patients, Study Reveals

Approximately 20% of adults undergoing lung cancer screening met criteria for undiagnosed chronic obstructive pulmonary disease (COPD), according to new data from a study presented at the American Thoracic Society (ATS) 2026 International Conference. The findings highlight a critical gap in identifying smoking-related lung disease during routine cancer screenings.

High Prevalence of Missed COPD Diagnoses

The study, led by Dr. Stephen Dachert, assistant professor of clinical thoracic medicine at the Lewis Katz School of Medicine at Temple University, analyzed data from 305 adults enrolled in the Temple Healthy Chest Initiative. Researchers found that 21% of participants met criteria for undiagnosed COPD based on airflow obstruction and symptoms assessed via the COPD Airway Assessment Test (CAAT).

Among those without a prior COPD diagnosis, 31.2% showed evidence of airflow obstruction, and 97% reported symptoms such as mucus production, cough, and breathlessness. Over 60% of these patients received no inhaler therapy, with only 10% receiving short-acting beta 2-agonists alone.

Implications for Lung Cancer Screening Programs

“Lung cancer screening programs are well established, but COPD remains frequently underrecognized despite detectable respiratory symptoms and structural lung abnormalities,” Dachert noted. The study underscores the potential for integrating spirometry and symptom assessments into lung cancer screening to identify and treat COPD earlier.

Dr. Jesse R. Sherratt, a pulmonologist at the University of Texas Health Science Center, emphasized the importance of these findings. “Incorporating spirometry and symptom evaluation into lung cancer screening could improve outcomes, particularly for underserved populations,” he said.

Limitations and Future Research

The study’s results, limited to a single region, may not be generalizable. However, the high rates of undiagnosed COPD and undertreatment suggest systemic challenges in recognizing smoking-related lung disease. Researchers recommend further studies to evaluate whether integrated screening improves quality of life, exacerbation rates, and healthcare utilization.

“Longitudinal studies could clarify whether earlier COPD identification during lung cancer screening alters disease progression,” Dachert added. The research was supported by grants from AstraZeneca and the Temple Lung Center.

Key Takeaways

• 20% of lung cancer screening patients had undiagnosed COPD.
• Over 60% of undiagnosed COPD patients received no inhaler therapy.
• Integrating spirometry and symptom assessments into lung cancer screening may improve COPD detection.
• Further research is needed to address disparities in COPD diagnosis and treatment.

The findings reinforce the need for proactive approaches to identify and manage smoking-related lung diseases during cancer screenings, potentially reducing long-term healthcare burdens and improving patient outcomes.