Increase in chest CT scans leads to more incidental findings

(HealthDay)—The percentage of incidental pulmonary nodules identified increased from 2006 to 2012, according to a study published online July 27 in the American Journal of Respiratory and Critical Care Medicine.

Michael K. Gould, M.D., from Kaiser Permanente Southern California in Pasadena, and colleagues examined recent trends in pulmonary nodule identification. Members of an integrated health system, who had nodules measuring 4 to 30 mm, were identified through electronic health records and natural language processing.

The researchers found that over 200,000 adult members underwent 415,581 chest computed tomography (CT) examinations between 2006 and 2012. There was an increase in the annual frequency of chest CT imaging, from 1.3 to 1.9 percent of all adult members, while nodule identification frequency increased from 24 to 31 percent of all scans performed. Per 1,000 person-years, the annual rate of chest CT increased from 15.4 to 20.7, the rate of nodule identification increased from 3.9 to 6.6, and the rate of a new lung cancer diagnosis remained stable. By extrapolation, within two years, more than 4.8 million Americans underwent at least one chest CT scan and 1.57 million had a nodule identified.

"Incidental pulmonary nodules are an increasingly common consequence of routine medical care, with an incidence that is much greater than recognized previously," the authors write. "More frequent nodule identification has not been accompanied by increases in the diagnosis of cancerous nodules."

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