Recent Trends in the Identification of Incidental Pulmonary Nodules
Pulmonary nodules are common incidental findings, but information about their incidence in the era of computed tomography (CT) is lacking. To examine recent trends in pulmonary nodule identification. We used electronic health records and natural language processing to identify members of an integrat...
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| Vydáno v: | American journal of respiratory and critical care medicine Ročník 192; číslo 10; s. 1208 - 1214 |
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| Hlavní autoři: | , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
United States
American Thoracic Society
15.11.2015
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| Témata: | |
| ISSN: | 1073-449X, 1535-4970 |
| On-line přístup: | Získat plný text |
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| Abstract | Pulmonary nodules are common incidental findings, but information about their incidence in the era of computed tomography (CT) is lacking.
To examine recent trends in pulmonary nodule identification.
We used electronic health records and natural language processing to identify members of an integrated health system who had nodules measuring 4 to 30 mm. We calculated rates of chest CT imaging, nodule identification, and receipt of a new lung cancer diagnosis within 2 years of nodule identification, and standardized rates by age and sex to estimate the frequency of nodule identification in the U.S. population in 2010.
Between 2006 and 2012, more than 200,000 adult members underwent 415,581 chest CT examinations. The annual frequency of chest CT imaging increased from 1.3 to 1.9% for all adult members, whereas the frequency of nodule identification increased from 24 to 31% for all scans performed. The annual rate of chest CT increased from 15.4 to 20.7 per 1,000 person-years, and the rate of nodule identification increased from 3.9 to 6.6 per 1,000 person-years, whereas the rate of a new lung cancer diagnosis remained stable. By extrapolation, more than 4.8 million Americans underwent at least one chest CT scan and 1.57 million had a nodule identified, including 63,000 who received a new lung cancer diagnosis within 2 years.
Incidental pulmonary nodules are an increasingly common consequence of routine medical care, with an incidence that is much greater than recognized previously. More frequent nodule identification has not been accompanied by increases in the diagnosis of cancerous nodules. |
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| AbstractList | Pulmonary nodules are common incidental findings, but information about their incidence in the era of computed tomography (CT) is lacking.
To examine recent trends in pulmonary nodule identification.
We used electronic health records and natural language processing to identify members of an integrated health system who had nodules measuring 4 to 30 mm. We calculated rates of chest CT imaging, nodule identification, and receipt of a new lung cancer diagnosis within 2 years of nodule identification, and standardized rates by age and sex to estimate the frequency of nodule identification in the U.S. population in 2010.
Between 2006 and 2012, more than 200,000 adult members underwent 415,581 chest CT examinations. The annual frequency of chest CT imaging increased from 1.3 to 1.9% for all adult members, whereas the frequency of nodule identification increased from 24 to 31% for all scans performed. The annual rate of chest CT increased from 15.4 to 20.7 per 1,000 person-years, and the rate of nodule identification increased from 3.9 to 6.6 per 1,000 person-years, whereas the rate of a new lung cancer diagnosis remained stable. By extrapolation, more than 4.8 million Americans underwent at least one chest CT scan and 1.57 million had a nodule identified, including 63,000 who received a new lung cancer diagnosis within 2 years.
Incidental pulmonary nodules are an increasingly common consequence of routine medical care, with an incidence that is much greater than recognized previously. More frequent nodule identification has not been accompanied by increases in the diagnosis of cancerous nodules. RATIONALEPulmonary nodules are common incidental findings, but information about their incidence in the era of computed tomography (CT) is lacking.OBJECTIVESTo examine recent trends in pulmonary nodule identification.METHODSWe used electronic health records and natural language processing to identify members of an integrated health system who had nodules measuring 4 to 30 mm. We calculated rates of chest CT imaging, nodule identification, and receipt of a new lung cancer diagnosis within 2 years of nodule identification, and standardized rates by age and sex to estimate the frequency of nodule identification in the U.S. population in 2010.MEASUREMENTS AND MAIN RESULTSBetween 2006 and 2012, more than 200,000 adult members underwent 415,581 chest CT examinations. The annual frequency of chest CT imaging increased from 1.3 to 1.9% for all adult members, whereas the frequency of nodule identification increased from 24 to 31% for all scans performed. The annual rate of chest CT increased from 15.4 to 20.7 per 1,000 person-years, and the rate of nodule identification increased from 3.9 to 6.6 per 1,000 person-years, whereas the rate of a new lung cancer diagnosis remained stable. By extrapolation, more than 4.8 million Americans underwent at least one chest CT scan and 1.57 million had a nodule identified, including 63,000 who received a new lung cancer diagnosis within 2 years.CONCLUSIONSIncidental pulmonary nodules are an increasingly common consequence of routine medical care, with an incidence that is much greater than recognized previously. More frequent nodule identification has not been accompanied by increases in the diagnosis of cancerous nodules. |
| Author | Suh, David E. Liu, In-Lu Amy Di Fiore, Jamie L. Zheng, Chengyi Tang, Tania Lee, Janet Danforth, Kim N. Gould, Michael K. Kosco, Anne E. |
| Author_xml | – sequence: 1 givenname: Michael K. surname: Gould fullname: Gould, Michael K. organization: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California – sequence: 2 givenname: Tania surname: Tang fullname: Tang, Tania organization: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California – sequence: 3 givenname: In-Lu Amy surname: Liu fullname: Liu, In-Lu Amy organization: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California – sequence: 4 givenname: Janet surname: Lee fullname: Lee, Janet organization: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California – sequence: 5 givenname: Chengyi surname: Zheng fullname: Zheng, Chengyi organization: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California – sequence: 6 givenname: Kim N. surname: Danforth fullname: Danforth, Kim N. organization: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California – sequence: 7 givenname: Anne E. surname: Kosco fullname: Kosco, Anne E. organization: Kaiser Permanente Los Angeles Medical Center, Los Angeles, California – sequence: 8 givenname: Jamie L. surname: Di Fiore fullname: Di Fiore, Jamie L. organization: Kaiser Permanente Baldwin Park Medical Center, Baldwin Park, California; and – sequence: 9 givenname: David E. surname: Suh fullname: Suh, David E. organization: Kaiser Permanente West Los Angeles Medical Center, Los Angeles, California |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26214244$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1093/jnci/dju284 10.1377/hlthaff.27.6.1491 10.1097/JTO.0b013e31825bd9f5 10.1378/chest.12-2351 10.1001/jama.2012.5960 10.1148/radiol.2372041887 10.1378/chest.127.4.1136 10.7812/TPP/12-031 10.1001/jama.1958.02990030008003 10.1001/jama.2012.5521 10.1164/ajrccm.162.3.9812152 10.6004/jnccn.2012.0023 10.1016/S0140-6736(99)06093-6 10.7326/0003-4819-158-4-201302190-00004 10.3949/ccjm.55.1.68 10.1056/NEJMcp012290 |
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To examine recent... RATIONALEPulmonary nodules are common incidental findings, but information about their incidence in the era of computed tomography (CT) is lacking.OBJECTIVESTo... |
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