Prevalence of non-calcified pulmonary nodules in screening chest computed tomography

• Published in: Thoracic cancer 2013-11, Vol.4 (4), p.405-409
• Main Authors: Ju, Sun Mi, Park, Hyun Bum, Kang, Hyunwook, Park, Chan-Woo, Kim, Woojin, Seon, Hyun-Ju, Kim, Yun-Hyeon, Cho, Sunghee, Moon, Jai-Dong, Ban, Heejung, Kwon, Yong-Soo, Oh, In-Jae, Kim, Kyu-Sik, Kim, Yu-Il, Lim, Sung-Chul, Kim, Young-Chul
• Format: Article
• Language: English
• Subjects: Computed tomography; early detection of cancer; lung neoplasms; pulmonary nodule
• ISSN: 1759-7706; 1759-7714
• DOI: 10.1111/1759-7714.12038

Background The National Lung Screening Trial revealed that low dose computed tomography (CT) screening reduced lung cancer mortality by 20%. However, nearly all (96.4%) of the positive screening results were false‐positive. A higher false‐positive rate (FPR) is expected in Korea, where the prevalence of tuberculosis and parasitic diseases are high. Material and methods We retrospectively reviewed the records of 1587 cases (906 males, 57.1%; 495 females, 31.2%) in which chest CT was used for health screening from 2006 to 2011 in one institution. The mean ± standard deviation age of the subjects was 62.7 ± 5.7 years and 495 (31.2%) subjects had a smoking history. Results Three hundred and thirty six subjects (21.2%) had non‐calcified pulmonary nodules (NCPNs) described as solid nodules (n = 319), masses (n = 15) or pure or mixed ground glass opacities (n = 36). The incidence of NCPNs was 23.8% in smokers and 20.0% in non‐smokers (P = 0.08). During a median follow up duration of 37 months (range, 0–67 months), eight subjects were confirmed to have lung cancer. Positive predictive value (PPV) of positive CT screening was 2.4% and FPR was 97.6%. Among 495 subjects who had a smoking history, 118 subjects displayed NCPNs (23.8%) and four patients were diagnosed with lung cancer, with a PPV and FPR of 3.4% and 96.6%, respectively. Conclusion CT screening has low PPV and high FPR, even in subjects with a high risk of lung cancer.