WCLC 2025 - Posters & ePosters-P1.04.11 New Nodule Lung Cancer in the UK Lung Cancer Screening Trial: Characteristics and Comparison With NELSON

Pdf Summary

This study investigates the incidence and lung cancer risk associated with new pulmonary nodules detected in the UK Lung Screening Trial (UKLS), involving 4,055 high-risk individuals aged 50-75 years. New nodules present a screening challenge due to their higher malignancy risk compared to baseline nodules. The trial used a single screening followed by short-term (3-month) and 12-month follow-ups, evaluating risk through initial nodule volume and maximum volume doubling time (VDTmax), a measure of growth rate. Cancer diagnoses were confirmed by histology, while benign status was assigned after 10 years without cancer.<br /><br />Among 875 participants with follow-up data, 233 new nodules were found in 142 individuals (16%), predominantly solid nodules. All five cancers identified occurred in solid nodules, with no malignancies in subsolid nodules. The study observed a distinctive "interval effect": short-term follow-up showed a high incidence of new nodules (16.7%) but no cancers, while the 12-month follow-up demonstrated lower incidence (8.4%) but all cancer cases (7.4%). This suggests new nodules detected earlier are more likely benign, while those detected at one year carry significant malignancy risk.<br /><br />Risk stratification indicated cancer probability increases with larger initial nodule volume and faster growth (shorter VDTmax). Both volume and VDTmax were found to be equally important predictors for cancer risk at 12 months. The study recommends a differentiated clinical approach: a conservative strategy for short-term detected nodules due to negligible malignancy risk, and comprehensive assessment incorporating both volume and growth rate for nodules found at annual screening.<br /><br />In conclusion, new subsolid nodules have negligible malignancy risk, and timing of detection critically influences cancer risk assessment. This work aids in optimizing lung cancer screening follow-up protocols by balancing early detection and overdiagnosis.

Asset Subtitle

Michael Davies

Meta Tag

Speaker Michael Davies

Topic Screening and Early Detection

Keywords

UK Lung Screening Trial

pulmonary nodules

lung cancer risk

nodule volume

volume doubling time

VDTmax

solid nodules

subsolid nodules

cancer risk stratification

lung cancer screening follow-up