Early detection key to pulmonary fibrosis

A dry cough or shortness of breath can often be taken as a sign of ageing, or asthma.
 
However, a simple CT scan might reveal a more sinister cause – one that, if found early, can make a life-saving difference.
 
Pulmonary fibrosis (PF) is a group of conditions that causes irreversible scarring of the lungs.
 
Mainly affecting people over 60 years of age, it is the most common interstitial lung disease in Australia, causing symptoms including gradual onset of breathlessness, dry cough and weight loss, and eventual respiratory failure.
 
More than 1250 people are diagnosed with idiopathic pulmonary fibrosis (IPF), the most common type of PL, in Australia every year.
 
And the prevalence of IPF is on the rise, with crude incidence increasing from 7.5 per 100,000 in 1997, to 14.2 per 100,000 in 2018, and projections to increase to 16.3 per 100,000 by 2025.
 
PF cannot be cured, but its progression can be slowed – with the aid of early detection.
 
September is Pulmonary Fibrosis Awareness Month 2025, for which leading clinicians, including Chair of RACGP Specific Interests Respiratory Medicine, Dr Kerry Hancock, have united to deliver an urgent message – early diagnosis saves lives.
 
And ‘early diagnosis starts in general practice’, says Dr Hancock.
 
Last week, Dr Hancock presented a video for GPs on behalf of the Centre of Research Excellence in Pulmonary Fibrosis, in which she discusses the common symptoms, including the telltale ‘velcro-type crackles’ when listening to the lungs.
 
However, as most symptoms are similar to other lung disorders, a high-resolution CT scan is required to formally diagnose PF, she says.
 
Once diagnosed, Dr Hancock recommends that GPs refer patients to a respiratory specialist, for the more complex process of determining what sort of PF is present.
 
Professor Tamera Corte, Director of Interstitial Lung Disease at Royal Prince Alfred Hospital, said a diagnosis may be delayed for years.
 
‘People with PF present to their GP with symptoms of breathlessness and cough more than the healthy population, even up to 10 years before diagnosis,’ she says.
 
‘This delay can mean they miss the critical early window for treatment.’
 
Dr Hancock said GPs ‘need to be alert to the signs and refer patients early to respiratory specialists’.
 
‘It’s vital we act quickly, as earlier diagnosis means earlier treatment, and better outcomes,’ she said.

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