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Self-reported exercise capacity among current smokers eligible for lung cancer screening: Distribution and association with key comorbidities
Journal article   Open access   Peer reviewed

Self-reported exercise capacity among current smokers eligible for lung cancer screening: Distribution and association with key comorbidities

Anne C. Melzer, Abbie Begnaud, Bruce R. Lindgren, Kelsey Schertz, Steven S. Fu, David M. Vock, Alexander J. Rothman and Anne M. Joseph
Cancer treatment and research communications, Vol.28, pp.100443-100443
2021
DOI: 10.1016/j.ctarc.2021.100443
PMID: 34371253
url
https://doi.org/10.1016/j.ctarc.2021.100443View
Published (Version of record) Open Access

Abstract

•Poor exercise capacity is common among individuals who smoke and are eligible for lung cancer screening, with only 39% reporting good exercise capacity.•Poor exercise capacity is strongly associated with chronic obstructive pulmonary disease and the presence of multiple comorbid conditions including congestive heart failure.•More research is needed as to how exercise capacity should be considered when completing shared decision-making for lung cancer screening. as lung cancer screening (LCS) is implemented is that patients will be screened who are too ill to benefit. Poor exercise capacity (EC) predicts adverse outcomes following lung resection. Describe the distribution of EC among smokers eligible for LCS and examine associations with comorbidities. Cross-sectional analysis of baseline data from a randomized controlled trial of tobacco treatment in the context of LCS. Participants responded regarding limitations in moderate activities, ability to climb stairs, and frequency of dyspnea on a scale from never/almost never to all or most of the time. Responses were assigned a numeric score and summed to categorize exercise limitation. Associations between poor EC and key comorbidities were examined using adjusted logistic regression. 660 participants completed a survey with the following characteristics: 64.4% male, 89.5% white, mean age 64.5. Overall EC categories were: good 39.0%, intermediate 41.6%, and poor 19.4%.  Prevalence of poor EC was higher among patients with COPD (OR 4.62 95%CI 3.05–7.02), heart failure (OR 3.07 95%CI 1.62–5.82) and cardiovascular disease (OR 2.24, 95%CI 1.45–3.47), and was highest among patients with multimorbidity. Among patients with COPD and heart failure, 57% had poor and 0% had good EC. In adjusted logistic regression, only COPD and Charlson comorbidity index remained significantly associated with poor EC. Many patients eligible for LCS reported poor EC, with increased odds of poor EC among patients with comorbidities. More research is needed to determine how to best integrate EC and comorbidity into eligibility and shared decision-making conversations.
 Cancer screening Comorbidity Exercise capacity Functional capacity Lung cancer Lung cancer screening Multimorbidity

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