Abstract
BackgroundThe discovery of a solitary pulmonary nodule (SPN) on a chest imaging exam is of major clinical concern. However, the incidence rates of SPNs in a general population have not been estimated. The objective of this study was to provide incidence estimates of SPNs in a general population in 5 northeastern regions of France.MethodsThis population-based study was undertaken in 5 regions of northeastern France in May 2002-March 2003 and May 2004-June 2005. SPNs were identified by chest CT reports collected from all radiology centres in the study area by trained readers using a standardised procedure. All reports for patients at least 18 years old, without a previous history of cancer and showing an SPN between 1 and 3 cm, were included.ResultsA total of 11,705 and 20,075 chest CT reports were collected for the 2002–2003 and 2004–2005 periods, respectively. Among them, 154 and 297 reports showing a SPN were included, respectively for each period. The age-standardised incidence rate (IR) was 10.2 per 100,000 person-years (95% confidence interval 8.5–11.9) for 2002–2003 and 12.6 (11.0–14.2) for 2004–2005. From 2002 to 2005, the age-standardised IR evolved for men from 16.4 (13.2–19.6) to 17.7 (15.0–20.4) and for women from 4.9 (3.2–6.6) to 8.2 (6.4–10.0). In multivariate Poisson regression analysis, gender, age, region and period were significantly associated with incidence variation.ConclusionsThis study provides reference incidence rates of SPN in France. Incidence was higher for men than women, increased with age for both gender and with time for women. Trends in smoking prevalence and improvement in radiological equipment may be related to incidence variations.
Highlights
The discovery of a solitary pulmonary nodule (SPN) on a chest imaging exam is of major clinical concern
This study aimed to estimate incidence rates of SPNs in a general population in 5 northeastern regions of France for two periods and to identify factors associated with differences in incidence, using data collected within the framework of a medico-economic evaluation program
Chest computed tomography (CT) was prescribed by a specialised physician in approximately 70% of cases, otherwise by a general practitioner
Summary
The discovery of a solitary pulmonary nodule (SPN) on a chest imaging exam is of major clinical concern. The discovery of a solitary pulmonary nodule (SPN) on a chest imaging exam has been of major clinical concern since the 1950s and has become common in current clinical practice since the widespread use of computed tomography (CT) [1,2,3]. Unless a registration system of ambulatory care diagnosis has been set up, common sources of medical information, such as health insurance or hospital discharge data in France, fail to identify all cases. Another difficulty in the identification of incident cases is to ensure that the presence of the nodule has not been noticed before. As the epidemiology of pulmonary nodules evolves with imaging practices, a point estimate of SPN incidence is essential to analyse future trends [12]
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