Introduction The finding of a solitary pulmonary nodule (SPN) (<3 cm) in routine radiological examination may represent an early stage of lung cancer or a benign lesion, where any further diagnostic procedures may pose an unnecessary risk to patient health. Although SPNs have been described in high risk populations, their frequency in routine clinical care has not been determined.
Methods 4681 consecutive patients ≥35 years referred for a thoracic imaging test in two hospitals in the Community of Valencia, Spain in 2010 were included. Six expert radiologists independently classified each imaging report according to the presence or absence of a SPN. Other variables, such as patient demographics diagnosis suspicion, smoking habit, the referral clinical department, type of radiological test performed, and clinical setting were ascertained from medical records. The association between SPNs and patient/clinical characteristics was assessed with unconditional logistic regression.
Results SPNs were observed in 351 patients (7.5%) and their prevalence varied according to patient characteristics and the referral department, with oncology (15.4%), primary care (10.7%) and pneumology (9.8%), being the highest. After controlling for other factors, SPNs were more common in men (aOR 1.47, 95% CI 1.25 to 1.75), and in smokers (aOR 1.62, 95% CI 1.41 to 1.82).
Conclusions At least one in every 13 patients undergoing a thoracic imaging test during routine clinical care will show a SPN. The follow-up of these patients is needed in order to estimate their predictive value for lung cancer, and avoid the initiation of an unnecessary cascade of clinical procedure in benign lesions.
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