Incidence of Pulmonary Nodules Needed to Improve Screening Programs

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The researchers estimated the incidence rates of pulmonary nodules to be between 6.17 and 97.35 per 10,000 person-years, depending on age.
The researchers estimated the incidence rates of pulmonary nodules to be between 6.17 and 97.35 per 10,000 person-years, depending on age.

This article is part of Pulmonology Advisor's coverage of the CHEST 2018 meeting, taking place in San Antonio, Texas. Our staff will report on medical research related to COPD, critical care medicine, and more conducted by experts in the field. Check back regularly for more news from CHEST 2018.


SAN ANTONIO — Accurate and contemporary incidence of pulmonary nodules is vital to guide implementation of better screening programs and identify at-risk populations, according to research presented at the CHEST Annual Meeting, held October 6-10, in San Antonio, Texas.

Researchers sought to determine the incidence of clinically relevant pulmonary nodules by querying an insurance claims database (TRICARE) of more than 9 million people, including members of the military and their families. Individuals were included if they had no nodules in the previous year while enrolled in TRICARE. Individuals with prior diagnoses of pulmonary nodules, cancer history, or metastases were excluded.

A total of 229,552 incident pulmonary nodules were identified in the initial query. The incidence rates ranged from 15.29 pulmonary nodules per 10,000 person-years in adults ages 18 to 24 to 198.81 per 10,000 person-years in adults ages 55 to 64. In their presentation, the researchers explained the number of pulmonary nodules may have been unusually high because of the military population in TRICARE. These individuals could have been exposed to various elements in their deployments that the average American would not be.

However, once the researchers applied their algorithm based on the Fleischner and American Association for Thoracic Surgery clinical management and follow-up guidelines, the number of pulmonary nodules decreased by approximately 60% to 88,628. This altered the incidence rates to 6.17 pulmonary nodules per 10,000 person-years in the 18 to 24 age range and 97.35 per 10,000 person-years in the 55 to 64 age range.

The researchers cautioned that more studies are needed to validate the true incidence of pulmonary nodules, particularly since data are limited and the “clinical importance of nodules detected by modern imaging is unknown.”

Disclosures: Some authors report financial relationships with pharmaceutical companies. Please see the reference link for full disclosures.

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Reference

Iñiguez CB, Kown N, Jacobson F, et al. Estimating incidence of solitary pulmonary nodules: novel methods using claims data to answer unknown epidemiological questions. Presented at: CHEST Annual Meeting 2018; October 6-10, 2018; San Antonio, TX.