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VIEW ALL NEWSFurther testing justified for smokers with hemoptysis and normal chest x-ray
NEW YORK (Reuters Health) - Clinicians should continue to evaluate smokers with hemoptysis even if the chest x-ray is normal as nearly 10% of these patients will have malignancy, say researchers from the UK.
Because the optimal strategy for investigating these patients remains unclear, Dr. David C. Currie and colleagues from Mid Yorkshire Hospitals NHS Trust, West Yorkshire, analyzed data from 270 patients with hemoptysis and a normal chest x-ray to see whether further investigations were justified.
Fiberoptic bronchoscopy was performed in 269 patients, and CT was performed in 257 patients, according to the report in the October Thorax.
Twenty-six of these patients (9.7%) were found to have a respiratory tract malignancy, and 9 of these were candidates for radical treatment. Six had curative surgical resection, 1 had radical radiotherapy, and 1 had photodynamic therapy, whereas 1 patient with non-small cell lung cancer refused radical treatment.
This cancer detection rate is similar to the 0-16% rate found in previous studies, the investigators say.
Nineteen of the patients were diagnosed as a result of their fiberoptic bronchoscopy, and 24 of those diagnosed had CT findings suggestive of cancer.
Based on these findings, the researchers conclude that "further investigation of hemoptysis in smokers with a normal chest radiograph is justified regardless of the amount or frequency of hemoptysis. We recommend that these patients are investigated with CT followed by bronchoscopy."
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