Distribution of Solid Lung Nodules Presence and Size by Age and Sex in a Northern European Nonsmoking Population

Background: Most of the data regarding prevalence and size distribution of solid lung nodules originates from lung cancer screening studies that target high-risk populations or from Asian general cohorts. In recent years, the identification of lung nodules in non-high-risk populations, scanned for clinical indications, has increased. However, little is known about the presence of solid lung nodules in the Northern European nonsmoking population.

Purpose: To study the prevalence and size distribution of solid lung nodules by age and sex in a nonsmoking population.

Materials and Methods: Participants included nonsmokers (never or former smokers) from the population-based Imaging in Lifelines study conducted in the Northern Netherlands. Participants (age ≥ 45 years) with completed lung function tests underwent chest low-dose CT scans. Seven trained readers registered the presence and size of solid lung nodules measuring 30 mm 3 or greater using semiautomated software. The prevalence and size of lung nodules (≥30 mm 3), clinically relevant lung nodules (≥100 mm 3), and actionable nodules (≥300 mm 3) are presented by 5-year categories and by sex.

Results: A total of 10 431 participants (median age, 60.4 years [IQR, 53.8-70.8 years]; 56.6% [ n = 5908] female participants; 46.1% [ n = 4812] never smokers and 53.9% [ n = 5619] former smokers) were included. Of these, 42.0% ( n = 4377) had at least one lung nodule (male participants, 47.5% [2149 of 4523]; female participants, 37.7% [2228 of 5908]). The prevalence of lung nodules increased from age 45-49.9 years (male participants, 39.4% [219 of 556]; female participants, 27.7% [236 of 851]) to age 80 years or older (male participants, 60.7% [246 of 405]; female participants, 50.9% [163 of 320]). Clinically relevant lung nodules were present in 11.1% (1155 of 10 431) of participants, with prevalence increasing with age (male participants, 8.5%-24.4%; female participants, 3.7%-15.6%), whereas actionable nodules were present in 1.1%-6.4% of male participants and 0.6%-4.9% of female participants. Conclusion Lung nodules were present in a substantial proportion of all age groups in the Northern European nonsmoking population, with slightly higher prevalence for male participants than female participants. © RSNA, 2024 Supplemental material is available for this article.