Relationship between Incidental Abnormalities on Screening Thoracic Computed Tomography and Mortality: A Long-Term Follow-Up Analysis

Lee, Jong Eun; Jeong, Won Gi; Lee, Hyo-Jae; Kim, Yun‐Hyeon; Chae, Kum Ju; Jeong, Yohan

doi:10.3348/kjr.2022.0131

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…Suffering from emphysema can increase the risk of all-cause mortality, and lung nodules have no obvious significance for all-cause mortality. Similarly, Lee's study [42] also revealed that emphysema was associated with long-term all-cause mortality; suspicious nodules were not identified as an independent risk factor for all-cause mortality in the multivariable Cox proportional hazards regression analysis. The mechanism that emphysema and lung nodules have different effects on lung cancer risk and all-cause mortality risk needs more research to explore.…”

Section: Discussionmentioning

confidence: 89%

Association of Lung Cancer Risk With the Presence of Both Lung Nodules and Emphysema in a Lung Cancer Screening Trial

Liu,

Feng,

Liu

et al. 2024

World J Oncol

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Background The coexistence of emphysema and lung nodules could interact with each other and then lead to potential higher lung cancer risk. The study aimed to explore the association between emphysema combined with lung nodules and lung cancer risk. Methods A total of 21,949 participants from the National Lung Screening Trial (NLST) who underwent low-dose computed tomography (LDCT) examination were included. Participants were categorized into four groups (NENN group (non-emphysema and non-nodules), E group (emphysema without nodules), N group (nodules without emphysema), and E + N group (nodules with emphysema)) according to whether there were lung nodules and emphysema. Multivariable Cox regression and stratified analyses were performed to estimate the association between the four groups and lung cancer risk. Results Among the 21,949 participants, there were 9,040 (41.2%), 5,819 (26.5%), 4,737 (21.6%), and 2,353 (10.7%) participants in the NENN group, E group, N group, and E + N group. The risk of lung cancer incidence increased in turn in NENN group, E group, N group and E + N group. Compared with NENN group, the age-adjusted hazard ratios (HRs) (95% confidence intervals (CIs)) of lung cancer incidence were 2.07 (1.69 - 2.54) for E group, 4.13 (3.47 - 5.05) for N group, and 6.26 (5.14 - 7.62) for E + N group. The association was robust to adjustment for potential confounders (1.83 (1.47 - 2.27) for E group, 3.97 (3.24 - 4.86) for N group, and 5.23 (4.28 - 6.48) for E + N group). Comparable results as the lung cancer incidence were observed for lung cancer mortality, whether in age-adjusted model (E group: 1.85 (1.39 - 2.46), N group: 2.49 (1.89 - 3.29), E + N group: 4.27 (3.21 - 5.68)) or fully adjusted model (E group: 1.56 (1.15 - 2.11), N group: 2.43 (1.81 - 3.26), E + N group: 3.39 (2.50 - 4.61)). However, the trend of all-cause mortality risk among the four groups was somewhat different from that of lung cancer risk, whether in age-adjusted model (1.37 (1.21 - 1.54) for E group, 1.06 (0.92 - 1.21) for N group, and 1.75 (1.51 - 2.02) for E + N group) or fully adjusted model (1.26 (1.10 - 1.44) for E group, 1.09 (0.94 - 1.27) for N group, and 1.52 (1.30 - 1.79) for E + N group). Conclusion Based on a large-scale lung cancer screening trial in the United States, this study demonstrated that either emphysema or lung nodules can increase lung cancer risk, and lung nodules combined with emphysema can further increase the lung cancer risk and all-cause mortality. The significance of these findings for lung cancer screening should be evaluated.

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Section: Discussionmentioning

confidence: 89%

Association of Lung Cancer Risk With the Presence of Both Lung Nodules and Emphysema in a Lung Cancer Screening Trial

Liu,

Feng,

Liu

et al. 2024

World J Oncol

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“…Among ten studies on the prognosis of ILA 3 , 9 , 11 , 16 – 18 , 26 , five focused on the general population 3 , 17 , 18 , 26 , while the remaining five specifically studied high-risk groups for lung cancer, such as individuals who smoke heavily 3 , 9 , 11 , 16 . The sample sizes ranged from 840 to 5320, with follow-up durations ranging from 3 to 12 years.…”

Section: Resultsmentioning

confidence: 99%

Clinical outcomes of interstitial lung abnormalities: a systematic review and meta-analysis

Seok,

Park,

Yoon

et al. 2024

Sci Rep

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Interstitial lung abnormalities (ILA), incidental findings on computed tomography scans, have raised concerns due to their association with worse clinical outcomes. Our meta-analysis, which included studies up to April 2023 from PubMed/MEDLINE, Embase, and Cochrane Library, aimed to clarify the impact of ILA on mortality, lung cancer development, and complications from lung cancer treatments. Risk ratios (RR) with 95% confidence intervals (CI) were calculated for outcomes. Analyzing 10 studies on ILA prognosis and 9 on cancer treatment complications, we found that ILA significantly increases the risk of overall mortality (RR 2.62, 95% CI 1.94–3.54; I2 = 90%) and lung cancer development (RR 3.85, 95% CI 2.64–5.62; I2 = 22%). Additionally, cancer patients with ILA had higher risks of grade 2 radiation pneumonitis (RR 2.28, 95% CI 1.71–3.03; I2 = 0%) and immune checkpoint inhibitor-related interstitial lung disease (RR 3.05, 95% CI 1.37–6.77; I2 = 83%) compared with those without ILA. In conclusion, ILA significantly associates with increased mortality, lung cancer risk, and cancer treatment-related complications, highlighting the necessity for vigilant patient management and monitoring.

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Opportunistic Screening for Coronary Artery Disease: An Untapped Population Health Resource

Malik,

Sun,

Azadi

et al. 2024

Journal of the American College of Radiology

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Relationship between Incidental Abnormalities on Screening Thoracic Computed Tomography and Mortality: A Long-Term Follow-Up Analysis

Cited by 3 publications

References 25 publications

Association of Lung Cancer Risk With the Presence of Both Lung Nodules and Emphysema in a Lung Cancer Screening Trial

Association of Lung Cancer Risk With the Presence of Both Lung Nodules and Emphysema in a Lung Cancer Screening Trial

Clinical outcomes of interstitial lung abnormalities: a systematic review and meta-analysis

Opportunistic Screening for Coronary Artery Disease: An Untapped Population Health Resource

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