Incidental pulmonary nodules may lead to a high proportion of early-stage lung cancer: but it requires more than a high CT volume to achieve this

Background The management of pulmonary nodules plays a critical role in early detection of lung cancer. Computed tomography (CT) has led to a stage-shift towards early-stage lung cancer, but regional differences in survival rates have been reported in Denmark. This study aimed to evaluate whether va...

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Main Authors: M. Borg, U. Bodtger, K. Kristensen, G. Alstrup, T. Mamaeva, A. Arshad, CB. Laursen, O. Hilberg, M. Brun Andersen, T Riis Rasmussen
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:European Clinical Respiratory Journal
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Online Access:https://www.tandfonline.com/doi/10.1080/20018525.2024.2313311
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author M. Borg
U. Bodtger
K. Kristensen
G. Alstrup
T. Mamaeva
A. Arshad
CB. Laursen
O. Hilberg
M. Brun Andersen
T Riis Rasmussen
author_facet M. Borg
U. Bodtger
K. Kristensen
G. Alstrup
T. Mamaeva
A. Arshad
CB. Laursen
O. Hilberg
M. Brun Andersen
T Riis Rasmussen
author_sort M. Borg
collection DOAJ
description Background The management of pulmonary nodules plays a critical role in early detection of lung cancer. Computed tomography (CT) has led to a stage-shift towards early-stage lung cancer, but regional differences in survival rates have been reported in Denmark. This study aimed to evaluate whether variations in nodule management among Danish health regions contributed to these differences.Material and Methods The Danish Health Data Authority and Danish Lung Cancer Registry provided data on CT usage and lung cancer stage distribution, respectively. Auditing of lung cancer stage IA patient referrals and nodule management of stage IV lung cancer patients was conducted in seven Danish lung cancer investigation centers, covering four of the five Danish health regions. CT scans were performed up to 2 years before the patients’ diagnosis from 2019 to 2021.Results CT usage has increased steadily in Denmark over the past decade, with a simultaneous increase in the proportion of early-stage lung cancers, particularly stage IA. However, one Danish health region, Region Zealand, exhibited lower rates of early-stage lung cancer and overall survival despite a CT usage roughly similar to that of the other health regions. The audit did not find significant differences in pulmonary nodule management or a higher number of missed nodules by radiologists in this region compared to others.Conclusion This study suggests that a high CT scan volume alone is not sufficient for the early detection of lung cancer. Factors beyond hospital management practices, such as patient-related delays in socioeconomically disadvantaged areas, may contribute to regional differences in survival rates. This has implications for future strategies for reducing these differences.
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spelling doaj-art-d4c55656850943fea41524988eee55922025-08-20T02:07:23ZengTaylor & Francis GroupEuropean Clinical Respiratory Journal2001-85252024-12-0111110.1080/20018525.2024.2313311Incidental pulmonary nodules may lead to a high proportion of early-stage lung cancer: but it requires more than a high CT volume to achieve thisM. Borg0U. Bodtger1K. Kristensen2G. Alstrup3T. Mamaeva4A. Arshad5CB. Laursen6O. Hilberg7M. Brun Andersen8T Riis Rasmussen9Department of Internal Medicine, Lillebaelt Hospital Vejle, Vejle, DenmarkRespiratory Research Unit PLUZ, Department of Respiratory Medicine, Zealand University Hospital Næstved & Roskilde, Næstved, DenmarkDepartment of Internal Medicine, Gødstrup Hospital, Herning, DenmarkRespiratory Research Unit PLUZ, Department of Respiratory Medicine, Zealand University Hospital Næstved & Roskilde, Næstved, DenmarkDepartment of Respiratory Medicine, Odense University Hospital, Odense, DenmarkDepartment of Respiratory Medicine, Odense University Hospital, Odense, DenmarkDepartment of Respiratory Medicine, Odense University Hospital, Odense, DenmarkDepartment of Internal Medicine, Lillebaelt Hospital Vejle, Vejle, DenmarkDepartment of Radiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, DenmarkDepartment of Respiratory Medicine and Allergy, Aarhus University Hospital, Aarhus, DenmarkBackground The management of pulmonary nodules plays a critical role in early detection of lung cancer. Computed tomography (CT) has led to a stage-shift towards early-stage lung cancer, but regional differences in survival rates have been reported in Denmark. This study aimed to evaluate whether variations in nodule management among Danish health regions contributed to these differences.Material and Methods The Danish Health Data Authority and Danish Lung Cancer Registry provided data on CT usage and lung cancer stage distribution, respectively. Auditing of lung cancer stage IA patient referrals and nodule management of stage IV lung cancer patients was conducted in seven Danish lung cancer investigation centers, covering four of the five Danish health regions. CT scans were performed up to 2 years before the patients’ diagnosis from 2019 to 2021.Results CT usage has increased steadily in Denmark over the past decade, with a simultaneous increase in the proportion of early-stage lung cancers, particularly stage IA. However, one Danish health region, Region Zealand, exhibited lower rates of early-stage lung cancer and overall survival despite a CT usage roughly similar to that of the other health regions. The audit did not find significant differences in pulmonary nodule management or a higher number of missed nodules by radiologists in this region compared to others.Conclusion This study suggests that a high CT scan volume alone is not sufficient for the early detection of lung cancer. Factors beyond hospital management practices, such as patient-related delays in socioeconomically disadvantaged areas, may contribute to regional differences in survival rates. This has implications for future strategies for reducing these differences.https://www.tandfonline.com/doi/10.1080/20018525.2024.2313311Lung cancerpulmonary nodulescomputed tomographysurvivalearly-stage lung cancer
spellingShingle M. Borg
U. Bodtger
K. Kristensen
G. Alstrup
T. Mamaeva
A. Arshad
CB. Laursen
O. Hilberg
M. Brun Andersen
T Riis Rasmussen
Incidental pulmonary nodules may lead to a high proportion of early-stage lung cancer: but it requires more than a high CT volume to achieve this
European Clinical Respiratory Journal
Lung cancer
pulmonary nodules
computed tomography
survival
early-stage lung cancer
title Incidental pulmonary nodules may lead to a high proportion of early-stage lung cancer: but it requires more than a high CT volume to achieve this
title_full Incidental pulmonary nodules may lead to a high proportion of early-stage lung cancer: but it requires more than a high CT volume to achieve this
title_fullStr Incidental pulmonary nodules may lead to a high proportion of early-stage lung cancer: but it requires more than a high CT volume to achieve this
title_full_unstemmed Incidental pulmonary nodules may lead to a high proportion of early-stage lung cancer: but it requires more than a high CT volume to achieve this
title_short Incidental pulmonary nodules may lead to a high proportion of early-stage lung cancer: but it requires more than a high CT volume to achieve this
title_sort incidental pulmonary nodules may lead to a high proportion of early stage lung cancer but it requires more than a high ct volume to achieve this
topic Lung cancer
pulmonary nodules
computed tomography
survival
early-stage lung cancer
url https://www.tandfonline.com/doi/10.1080/20018525.2024.2313311
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