incidental findings on chest X-ray or CT scans of COPD or emphysema

Last edited 03/2019 and last reviewed 07/2022

ncidental findings on chest X-rays or CT scans

  • primary care respiratory review and spirometry should be considered for people with emphysema or signs of chronic airways disease on a chest X-ray or CT scan

  • if the person is a current smoker, their spirometry results are normal and they have no symptoms or signs of respiratory disease:
    • offer smoking cessation advice and treatment, and referral to specialist stop smoking services
    • warn them that they are at higher risk of lung disease
    • advise them to return if they develop respiratory symptoms
    • be aware that the presence of emphysema on a CT scan is an independent risk factor for lung cancer

  • if the person is not a current smoker, their spirometry is normal and they have no symptoms or signs of respiratory disease:
    • ask them if they have a personal or family history of lung or liver disease and consider alternative diagnoses, such as alpha-1 antitrypsin deficiency
    • reassure them that their emphysema or chronic airways disease is unlikely to get worse
    • advise them to return if they develop respiratory symptoms
    • be aware that the presence of emphysema on a CT scan is an independent risk factor for lung cancer

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