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Publications

Journal Article Ahead of print

PubMed: 42031619 DOI: 10.1016/j.arbres.2026.03.010

Comparison of Lung Cancer Screening Programs in Liver Transplant Recipients and the General Population.

Arch Bronconeumol

Authors: Meylin Caballeros Lam, Paula Raquel Pujols LeĆ³n, Mercedes IƱarrairaegui, Ana Ezponda, Miguel Sogbe, Javier J Zulueta, Juan P de-Torres, Luis Seijo, Fernando Rotellar, Gorka Bastarrika, Jose I Herrero

Affiliations

  • Department of Radiology, ClĆ­nica Universidad de Navarra, Madrid, Spain.
  • Department of Internal Medicine, Hospital Universitario Gregorio MaraĆ±Ć³n, Madrid, Spain.
  • Liver Unit, ClĆ­nica Universidad de Navarra, Pamplona, Spain; CIBERehd, Madrid, Spain; IdiSNA, Pamplona, Spain.
  • Department of Radiology, ClĆ­nica Universidad de Navarra, Pamplona, Spain.
  • Liver Unit, ClĆ­nica Universidad de Navarra, Pamplona, Spain.
  • Chief Medical Officer, Qure.ai, India.
  • IdiSNA, Pamplona, Spain; Department of Pulmonary, ClĆ­nica Universidad de Navarra, Pamplona, Spain.
  • Department of Pulmonary, ClĆ­nica Universidad de Navarra, Madrid, Spain.
  • IdiSNA, Pamplona, Spain; Department of Surgery, ClĆ­nica Universidad de Navarra, Pamplona, Spain.
  • IdiSNA, Pamplona, Spain; Department of Radiology, ClĆ­nica Universidad de Navarra, Pamplona, Spain.
  • Liver Unit, ClĆ­nica Universidad de Navarra, Pamplona, Spain; CIBERehd, Madrid, Spain; IdiSNA, Pamplona, Spain.

Abstract

OBJECTIVES

The objectives of this study are to analyse whether liver transplant recipients (LTR) have a higher incidence of lung cancer (LC) compared to a population of high risk smokers enrolled in a LC screening program and to evaluate if LC screening results allow an early diagnosis in LTRs.

METHODS

We conducted a retrospective study comparing LC screening outcomes using low-dose computed tomography (LDCT) in 124 LTRs and 485 matched non-immunosuppressed controls. Matching criteria included age, sex, smoking history, active smoking status, and presence of emphysema. Tumour characteristics, staging, treatment, and survival were analysed.

RESULTS

LC was diagnosed in 9.7% of LTRs and 4.5% of controls (p=0.11). LTRs more frequently presented with squamous cell carcinoma, while adenocarcinoma predominated in controls. Early-stage diagnosis (stage IA) was more common in LTRs (83.4% vs. 50%, p=0.056). Survival after diagnosis was comparable between groups in the first three years, although LTRs showed reduced long-term survival. Multivariate analysis identified cumulative tobacco exposure>35 pack-years (HR=3.0; p=0.003), and centrilobular emphysema (HR: 2.8; p=0.004) as independent risk factors for LC, liver transplantation showed an association close to significance (HR: 1.9; p=0.08).

CONCLUSIONS

LTRs have a higher incidence of LC than matched non-immunosuppressed individuals. LDCT screening enables early detection and favourable outcomes. These findings support routine LC screening in high-risk LTRs, particularly those with significant smoking histories, and centrilobular emphysema.

MeSH

Liver Transplantation, Lung, Incidence, Emphysema, Neoplasms, Liver, Lung Neoplasms, Diagnosis, Transplants, History, Smoking