Have you noticed that there has been an endless stream of topics about lung nodules over the years?
my country’s “Expert Consensus on Low-dose Spiral CT Lung Cancer Screening” issued in 2015 advocates that high-risk groups of lung cancer should undergo low-dose chest CT examination at least once a year. With the popularization of low-dose CT, the detection rate of pulmonary nodules has also increased significantly from 8% to 51% [1].
Are lung nodules sure to develop into lung cancer?
No, there are benign and malignant pulmonary nodules. Malignant nodules are easy to develop into lung cancer, while benign nodules are rarely malignant into lung cancer.
Benign pulmonary nodules are mostly caused by bacterial pneumonia, fungal pneumonia, pulmonary fibrosis, viral pneumonia, etc. They are generally stable, don’t worry too much, and regular follow-up is enough .
Malignant pulmonary nodules are mostly caused by malignant tumor space-occupying diseases such as bronchial lung cancer and lung cancer. Generally, the nodules are irregular in shape, and obvious burrs will be seen on the edges of the nodules. Wait, it is necessary to be highly vigilant and strictly follow the doctor’s advice.
Image source: Figure Worm Creative
What nodules should be followed up?
Follow-up is the doctor’s tracking and inspection of the patient’s condition, so once you find that the condition needs to be followed up, don’t change the doctor casually, it will be detrimental to the doctor’s grasp of your condition. So, what kind of nodules need follow-up?
1) If the nodule diameter is ≤4mm and there are no risk factors, you will generally not be followed up; if there are risk factors, you will generally be re-examined and evaluated at 12 months.
2) If 4mm < nodule diameter ≤ 6mm, and there are no risk factors, you will be re-examined and evaluated at 12 months; month follow-up.
3) 6 mm < nodule diameter < 8 mm, even if there is no risk factor for lung cancer, follow-up should be conducted at 6, 12, 18 to 24 months; for those with risk factors, do not think too much 3 to 6, 9 to 12 months need follow-up.
4) The diameter of the nodule is ≥8mm. It should be taken seriously and strictly abide by the doctor’s diagnosis and treatment recommendations [2].
Image source: Figure Worm Creative
What are risk factors?
The risk factors mentioned here are lung cancer risk factors, including:
①Currently or ever smoking ≥20 packs/year (400 cigarettes/year), quit smoking <15 years; ②Have a history of environmental or high-risk occupational exposure (such as exposure to asbestos, beryllium, uranium, etc.) , radon, etc.); ③ associated with chronic obstructive pneumonia, diffuse pulmonary fibrosis, or a history of pulmonary tuberculosis; ④ a history of malignant tumor or family history of lung cancer.
If you have any of the above risk factors and your age is more than 40 years old, you belong to a high-risk group[2]. Don’t be lazy, check up on time, follow up in time, and get rid of bad habits such as staying up late and eating irregularly.
References:
[1] Siegel, RL., Miller, KD., and Jemal, A. Cancerstatistics, 2016. CAC ancer JClin. 2016, 66: 7-30.
[2] Chen Jing, Ye Xiaodan. Interpretation and comparison of guidelines for the management of pulmonary nodules[J]. Chinese Journal of Integrative Medicine Imaging, 2021,19(3):301-306.