Management of pulmonary nodules in non-high-risk population: initial evidence from a real-world prospective cohort study in China

According to the Chinese Expert Consensus on Diagnosis and Treatment of Pulmonary Nodules (2018 Edition), the high-risk population of lung cancer in China was defined as those who were over 40 years old and had any of the following risk factors: current smoking for >20 pack-years, or having ever smoked for >20 pack-years and quitting smoking within 15 years; having a history of environmental or high-risk occupational exposure (such as asbestos, beryllium, uranium, radon, etc.); complicated with chronic obstructive pulmonary diseases (COPD), diffuse pulmonary fibrosis or previous history of pulmonary tuberculosis; having a history of malignant tumor; having a family history of lung cancer. Totally, 2196 positive lung nodules were detected in the non-high-risk group, whereas 1374 positive nodules were found among the high-risk cohort. [...]September 30, 2020, the follow-up interval was between 0 and 30 months for all participants, with a median time of 16 months. The result strongly indicated that the screening and management for non-high-risk individuals, identified by the previous standard, should not be neglected. [...]up to 92.05% of the detected lung cancer patients in the non-high-risk cohort were in stage I, which was also similar to the clinical stage distribution of lung cancer patients with high-risk factors (92.05% [243/264] vs. 94.44% [119/126], χ2 = 15.429, P = 0.117). [...]the follow-up time of the cohort was not long enough and most of the patients with positive nodules are still being followed up