{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T13:54:43Z","timestamp":1761746083776,"version":"build-2065373602"},"reference-count":50,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Secretariat for Health Care of Vojvodina","award":["18024017"],"award-info":[{"award-number":["18024017"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background: Chronic obstructive pulmonary disease (COPD) and lung cancer are the leading causes of death globally, which share common risk factors such as age and smoking exposure. In high-income countries, low-dose computed tomography (LDCT) lung cancer screening programs have decreased lung cancer mortality and facilitated the detection of emphysema, a key radiological indicator of COPD. This study aimed to assess the prevalence of emphysema during a pilot LDCT screening program for lung cancer in a middle-income country with a high smoking prevalence. Methods: A secondary analysis of the Lung Cancer Screening Database of the Autonomous Province of Vojvodina, Serbia, from 20 September 2020 to 30 May 2022. Persons aged 50\u201374 years, with a smoking history of \u226530 pack-years\/or \u226520 pack-years with additional risks (chronic lung disease, prior pneumonia, malignancy other than lung cancer, family history of lung cancer, and professional exposure to carcinogens) were offered LDCT. Results: Of 1288 participants, mean age of 62.1 \u00b1 6.7 years and 535 males (41.5%), 386 (30.0%) had emphysema. The majority of patients with emphysema (301\/386, 78.0%) had no prior history of chronic lung diseases. Compared to the patients without emphysema, the patients with emphysema reported more shortness of breath (140\/386, 36.3% vs. 276\/902, 30.6%, p = 0.046), chronic cough (117\/386, 30.3% vs. 209\/902, 23.17% p = 0.007), purulent sputum expectoration (70\/386, 18.1% vs. 95\/902, 10.53%, p &lt; 0.001), and weight loss (45\/386, 11.7% vs. 63\/902, 7.0%, p = 0.005). The patients with emphysema had more exposure to smoking (pack\/years, 43.8 \u00b1 18.8 vs. 39.3 \u00b1 18.1, p &lt; 0.001) and higher prevalence of solid or semisolid lung nodules (141\/386, 36.5% vs. 278\/902 30.8%, p = 0.04). Conclusions: Almost one-third of the patients who underwent the LDCT screening program in a middle-income country had emphysema that was commonly undiagnosed despite being associated with a significant symptom burden. Spirometry screening should be considered in high-risk populations.<\/jats:p>","DOI":"10.3390\/diseases13050146","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T06:18:51Z","timestamp":1746771531000},"page":"146","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Prevalence of Emphysema in Patients Undergoing Lung Cancer Screening in a Middle-Income Country"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9560-3653","authenticated-orcid":false,"given":"Marija","family":"Vukoja","sequence":"first","affiliation":[{"name":"Institute for Pulmonary Diseases of Vojvodina, 21204 Sremska Kamenica, Serbia"},{"name":"Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dragan","family":"Dragisic","sequence":"additional","affiliation":[{"name":"Institute for Pulmonary Diseases of Vojvodina, 21204 Sremska Kamenica, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gordana","family":"Vujasinovic","sequence":"additional","affiliation":[{"name":"Institute for Pulmonary Diseases of Vojvodina, 21204 Sremska Kamenica, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jelena","family":"Djekic Malbasa","sequence":"additional","affiliation":[{"name":"Institute for Pulmonary Diseases of Vojvodina, 21204 Sremska Kamenica, Serbia"},{"name":"Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilija","family":"Andrijevic","sequence":"additional","affiliation":[{"name":"Institute for Pulmonary Diseases of Vojvodina, 21204 Sremska Kamenica, Serbia"},{"name":"Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Goran","family":"Stojanovic","sequence":"additional","affiliation":[{"name":"Institute for Pulmonary Diseases of Vojvodina, 21204 Sremska Kamenica, Serbia"},{"name":"Faculty of Pharmacy, University Business Academy in Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4733-0093","authenticated-orcid":false,"given":"Ivan","family":"Kopitovic","sequence":"additional","affiliation":[{"name":"Institute for Pulmonary Diseases of Vojvodina, 21204 Sremska Kamenica, Serbia"},{"name":"Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2100","DOI":"10.1016\/S0140-6736(24)00367-2","article-title":"GBD 2021 Causes of Death Collaborators Global Burden of 288 Causes of Death and Life Expectancy Decomposition in 204 Countries and Territories and 811 Subnational Locations, 1990\u20132021: A Systematic Analysis for the Global Burden of Disease Study 2021","volume":"403","author":"Naghavi","year":"2024","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.2147\/COPD.S380732","article-title":"From COPD to Lung Cancer: Mechanisms Linking, Diagnosis, Treatment, and Prognosis","volume":"17","author":"Qi","year":"2022","journal-title":"Int. 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