From the Departments of Epidemiology (J.C., M.V., G.H.d.B.), Radiology (G.J.P., G.K., R.V.), and Pulmonology (H.J.M.G.), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands; Department of Radiology, Medisch Spectrum Twente, University of Twente, the Netherlands (G.J.P.); and Department of Radiology, Martini Hospital Groningen, Groningen, the Netherlands (M.R., G.K.).
Radiology. 2024 Aug;312(2):e231436. doi: 10.1148/radiol.231436.
Background Most of the data regarding prevalence and size distribution of solid lung nodules originates from lung cancer screening studies that target high-risk populations or from Asian general cohorts. In recent years, the identification of lung nodules in non-high-risk populations, scanned for clinical indications, has increased. However, little is known about the presence of solid lung nodules in the Northern European nonsmoking population. Purpose To study the prevalence and size distribution of solid lung nodules by age and sex in a nonsmoking population. Materials and Methods Participants included nonsmokers (never or former smokers) from the population-based Imaging in Lifelines study conducted in the Northern Netherlands. Participants (age ≥ 45 years) with completed lung function tests underwent chest low-dose CT scans. Seven trained readers registered the presence and size of solid lung nodules measuring 30 mm or greater using semiautomated software. The prevalence and size of lung nodules (≥30 mm), clinically relevant lung nodules (≥100 mm), and actionable nodules (≥300 mm) are presented by 5-year categories and by sex. Results A total of 10 431 participants (median age, 60.4 years [IQR, 53.8-70.8 years]; 56.6% [ = 5908] female participants; 46.1% [ = 4812] never smokers and 53.9% [ = 5619] former smokers) were included. Of these, 42.0% ( = 4377) had at least one lung nodule (male participants, 47.5% [2149 of 4523]; female participants, 37.7% [2228 of 5908]). The prevalence of lung nodules increased from age 45-49.9 years (male participants, 39.4% [219 of 556]; female participants, 27.7% [236 of 851]) to age 80 years or older (male participants, 60.7% [246 of 405]; female participants, 50.9% [163 of 320]). Clinically relevant lung nodules were present in 11.1% (1155 of 10 431) of participants, with prevalence increasing with age (male participants, 8.5%-24.4%; female participants, 3.7%-15.6%), whereas actionable nodules were present in 1.1%-6.4% of male participants and 0.6%-4.9% of female participants. Conclusion Lung nodules were present in a substantial proportion of all age groups in the Northern European nonsmoking population, with slightly higher prevalence for male participants than female participants. © RSNA, 2024
背景 大多数关于实性肺结节的患病率和大小分布的数据来自于针对高危人群的肺癌筛查研究，或者来自于亚洲的一般队列。近年来，由于临床指征对非高危人群进行肺部结节的识别增加，因此非吸烟人群中实性肺结节的存在情况也有所增加。然而，对于北欧不吸烟人群中实性肺结节的存在情况知之甚少。目的 研究在北欧不吸烟人群中按年龄和性别划分的实性肺结节的患病率和大小分布。材料与方法 参与者包括来自在荷兰北部进行的基于人群的影像学在生命研究（Imaging in Lifelines study）中的不吸烟者（从不吸烟者或前吸烟者）。完成肺功能测试的参与者（年龄≥45 岁）接受了胸部低剂量 CT 扫描。7 名经过培训的读者使用半自动软件记录了大小为 30 毫米或以上的实性肺结节的存在和大小。按 5 年类别和性别列出了≥30 毫米的肺结节（结节）、≥100 毫米的临床相关肺结节（结节）和≥300 毫米的可行动性结节（结节）的患病率和大小。结果 共纳入了 10431 名参与者（中位年龄为 60.4 岁[四分位距（IQR），53.8-70.8 岁]；56.6%[=5908]为女性参与者；46.1%[=4812]为从不吸烟者，53.9%[=5619]为前吸烟者）。其中，42.0%（=4377）至少有一个肺结节（男性参与者为 47.5%[2149/4523]；女性参与者为 37.7%[2228/5908]）。肺结节的患病率从 45-49.9 岁年龄组（男性参与者为 39.4%[219/556]；女性参与者为 27.7%[236/851]）上升到 80 岁或以上年龄组（男性参与者为 60.7%[246/405]；女性参与者为 50.9%[163/320]）。11.1%（1155/10431）的参与者存在临床相关肺结节，患病率随年龄增长而增加（男性参与者为 8.5%-24.4%；女性参与者为 3.7%-15.6%），而可行动性结节在男性参与者中占 1.1%-6.4%，在女性参与者中占 0.6%-4.9%。结论 在北欧不吸烟人群中，所有年龄段的人群中都存在相当比例的肺结节，男性参与者的患病率略高于女性参与者。
