Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Epidemiology and Health Statistics, School of Public Health, Hangzhou Normal University, Hangzhou, China.
Eur Respir J. 2024 Jun 6;63(6). doi: 10.1183/13993003.01736-2023. Print 2024 Jun.
This population-based study aimed to identify the risk factors for lung nodules in a Western European general population.
We quantified the presence or absence of lung nodules among 12 055 participants of the Dutch population-based ImaLife (Imaging in Lifelines) study (age ≥45 years) who underwent low-dose chest computed tomography. Outcomes included the presence of 1) at least one solid lung nodule (volume ≥30 mm) and 2) a clinically relevant lung nodule (volume ≥100 mm). Fully adjusted multivariable logistic regression models were applied overall and stratified by smoking status to identify independent risk factors for the presence of nodules.
Among the 12 055 participants (44.1% male; median age 60 years; 39.9% never-smokers; 98.7% White), we found lung nodules in 41.8% (5045 out of 12 055) and clinically relevant nodules in 11.4% (1377 out of 12 055); the corresponding figures among never-smokers were 38.8% and 9.5%, respectively. Factors independently associated with increased odds of having any lung nodule included male sex, older age, low educational level, former smoking, asbestos exposure and COPD. Among never-smokers, a family history of lung cancer increased the odds of both lung nodules and clinically relevant nodules. Among former and current smokers, low educational level was positively associated with lung nodules, whereas being overweight was negatively associated. Among current smokers, asbestos exposure and low physical activity were associated with clinically relevant nodules.
The study provides a large-scale evaluation of lung nodules and associated risk factors in a Western European general population: lung nodules and clinically relevant nodules were prevalent, and never-smokers with a family history of lung cancer were a non-negligible group.
本研究旨在确定西方欧洲普通人群中肺部结节的危险因素。
我们对 12055 名年龄≥45 岁的荷兰基于人群的 ImaLife（影像学在生活中）研究参与者进行低剂量胸部 CT 检查，以评估肺部结节的存在情况。结果包括：1）至少有一个实性肺结节（体积≥30mm）和 2）一个临床相关的肺结节（体积≥100mm）。总体和按吸烟状况分层，采用多变量逻辑回归模型来识别结节存在的独立危险因素。
在 12055 名参与者中（44.1%为男性；中位年龄 60 岁；39.9%从不吸烟；98.7%为白人），我们发现 41.8%（5045/12055）的参与者存在肺部结节，11.4%（1377/12055）的参与者存在临床相关的肺结节；从不吸烟者中相应的比例分别为 38.8%和 9.5%。与存在肺部结节的几率增加独立相关的因素包括男性、年龄较大、教育程度较低、曾经吸烟、石棉暴露和 COPD。在从不吸烟者中，肺癌家族史增加了肺部结节和临床相关结节的几率。在曾经和现在吸烟者中，教育程度较低与肺部结节呈正相关，而超重与肺部结节呈负相关。在现在吸烟者中，石棉暴露和低体力活动与临床相关的肺结节有关。
本研究对西方欧洲普通人群中的肺部结节及其相关危险因素进行了大规模评估：肺部结节和临床相关的肺结节普遍存在，有肺癌家族史的从不吸烟者是一个不容忽视的群体。
