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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Vydané v:American journal of respiratory and critical care medicine Ročník 192; číslo 10; s. 1208 - 1214
Hlavní autori: Gould, Michael K., Tang, Tania, Liu, In-Lu Amy, Lee, Janet, Zheng, Chengyi, Danforth, Kim N., Kosco, Anne E., Di Fiore, Jamie L., Suh, David E.
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States American Thoracic Society 15.11.2015
Predmet:
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
California - epidemiology
Disease Progression
Electronic Health Records
Female
Humans
Incidence
Incidental Findings
Lung Neoplasms - diagnosis
Lung Neoplasms - epidemiology
Male
Managed Care Programs - statistics & numerical data
Middle Aged
Multiple Pulmonary Nodules - diagnostic imaging
Multiple Pulmonary Nodules - epidemiology
Radiography, Thoracic
Retrospective Studies
Sex Distribution
Solitary Pulmonary Nodule - diagnostic imaging
Solitary Pulmonary Nodule - epidemiology
Tomography, X-Ray Computed
Young Adult
computed tomography
lung cancer
coin lesion
ISSN:1073-449X, 1535-4970
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Shrnutí: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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ISSN:1073-449X
1535-4970
DOI:10.1164/rccm.201505-0990OC