P60 Temporally close presentation of primary lung cancer and idiopathic pulmonary fibrosis (IPF): an analysis of incident IPF cases from 2007 – 2018

Background Lung cancer is historically described as a late complication of IPF, implying that screening in early IPF would have a low yield. The frequency of finding lung cancer in newly diagnosed IPF is not known. Methods The Lung Cancer multidisciplinary team (LCM) database at the Royal Brompton Hospital was retrospectively examined for the period 2007–18 to identify cases with underlying IPF. Additionally, new ILD referrals seen over the same period were retrospectively filtered for cases with a final/MDT diagnosis of IPF. Results In the period of interest, 3267 cases of suspected lung cancer were referred by various parties to the LCM and a total of 1780 cases of IPF were diagnosed by the RBH ILD Unit. Of the latter, 61 were referred for exclusion of malignancy (mean age 70.7; 84% male; mean predicted FVC 80.1% and TLco 39.7%). Primary lung cancer was histologically confirmed in 30/61 (49.2%) cases and highly suspected in another 16 (26.2%) based on tumour behaviour and/or PET-FDG staging. The rate of cancer diagnosis amongst all IPF patients was therefore 2.6% (46/1780). Coexistent emphysema was present in exactly half (23/46) of this group. Cancer subtyping revealed 24 cases of non-small cell and 7 cases of small cell lung cancer. Patients considered unfit for biopsy had poorer lung function; FVC: 67.6%±21.9% vs. 84.9%±18.3% (P Conclusions Near-contemporaneous (