Five-year follow-up of hemoptysis with no malignancy suspected on chest computed tomography: recurrence, lung cancer and mortality

Background: Evidence from recent years suggests most cases of hemoptysis to be caused by non-malignant etiologies, but the long-term outcome for these patients has been less thoroughly investigated. Objective: We aimed to assess the rates of hemoptysis recurrence, new lung cancer diagnoses and death within 5 years of initial referral for hemoptysis. Design: In this retrospective study, we reviewed clinical records of consecutive patients referred to evaluation for hemoptysis with no malignancy suspected on chest computed tomography at Aalborg University Hospital, Denmark, in a seven-year period from 2006 to 2012. Results: A total of 609 patients (mean age 56.7 ± 14.1 years, 60.6% male) were included in the study. The etiology was cryptogenic in 81% of patients and no patients had malignant disease. In the following 5 years, lung cancer developed in 1.5% of patients. Median time to diagnosis was 26 (IQR 18–33) months. Nine percent of patients had at least one recurrence of hemoptysis, and the 5-year mortality rate was 12% with median time to death 31 (IQR 13–43) months. Conclusions: Lung cancer developed in less than 2% within 5 years after referral for hemoptysis with no malignancy suspected on chest computed tomography. Further research is needed to identify risk factors for the development of lung cancer in these patients.