Abstract
Introduction
We investigated whether incidence and outcome of new lung nodules was influenced by the influenza season in a LDCT lung cancer screening trial population.
Methods
Participants from the NELSON trial with ≥1 new nodule detected in screening rounds two and three were included. The influenza season (winter) was classified as 1st October to 31st March, and was compared to the hay-fever season (summer) 1st April to 30th September. Nodule outcome was reported as resolving, persisting, requiring immediate referral or requiring no additional screen. Additionally, all new nodules which were linked to lung cancers were reported as matched cancers in the dataset. Seasonal variance was tested using Chi-square Goodness-of-fit test, after correction for unequal distribution of incidence screening scans and new nodules detected across the seasons.
Results
In the 7,156 LDCT scans performed during screening rounds two and three (4029[56%] in winter versus 3127[44%] in summer), a total of 981 new nodules were reported for 613 participants. Of these new nodules, 597 (61%) were detected during winter which, after correction for seasonal distribution of incidence screening scans, was significantly more than the 384 (39%) detected during summer (p=0.002). Similarly, there were significantly more participants with ≥1 new nodule in winter compared to summer (373 [61%] versus 240 [39%] respectively, p<0.001). When looking at outcomes of the largest new nodule per participant, after correction for seasonal distribution of new nodules (373 in winter versus 240 in summer), no significant difference was found in the number of resolving nodules (191/373 in winter versus 140/240 in summer, p=0.219), persisting nodules (126/373 in winter versus 77/240 in summer, p=0.562), immediate referrals (49/373 in winter versus 21/240 in summer, p=0.123), or matched cancers (29/373 in winter versus 15/240 in summer, p=0.504). Furthermore, no variation was seen in new nodule type, size, or location per season.
Conclusions
Incidence of lung nodules on LDCT thorax scans in a lung cancer screening population is higher during the influenza season. However, resolution of new nodules and number of matched cancers appears comparable in both winter and summer. Hence, this study does not clarify whether seasonal respiratory illnesses are directly related to this increased incidence. Further investigation into seasonal incidence and outcome of baseline nodules in this population could help elucidate the cause of the higher incidence of nodules during the influenza months.
We investigated whether incidence and outcome of new lung nodules was influenced by the influenza season in a LDCT lung cancer screening trial population.
Methods
Participants from the NELSON trial with ≥1 new nodule detected in screening rounds two and three were included. The influenza season (winter) was classified as 1st October to 31st March, and was compared to the hay-fever season (summer) 1st April to 30th September. Nodule outcome was reported as resolving, persisting, requiring immediate referral or requiring no additional screen. Additionally, all new nodules which were linked to lung cancers were reported as matched cancers in the dataset. Seasonal variance was tested using Chi-square Goodness-of-fit test, after correction for unequal distribution of incidence screening scans and new nodules detected across the seasons.
Results
In the 7,156 LDCT scans performed during screening rounds two and three (4029[56%] in winter versus 3127[44%] in summer), a total of 981 new nodules were reported for 613 participants. Of these new nodules, 597 (61%) were detected during winter which, after correction for seasonal distribution of incidence screening scans, was significantly more than the 384 (39%) detected during summer (p=0.002). Similarly, there were significantly more participants with ≥1 new nodule in winter compared to summer (373 [61%] versus 240 [39%] respectively, p<0.001). When looking at outcomes of the largest new nodule per participant, after correction for seasonal distribution of new nodules (373 in winter versus 240 in summer), no significant difference was found in the number of resolving nodules (191/373 in winter versus 140/240 in summer, p=0.219), persisting nodules (126/373 in winter versus 77/240 in summer, p=0.562), immediate referrals (49/373 in winter versus 21/240 in summer, p=0.123), or matched cancers (29/373 in winter versus 15/240 in summer, p=0.504). Furthermore, no variation was seen in new nodule type, size, or location per season.
Conclusions
Incidence of lung nodules on LDCT thorax scans in a lung cancer screening population is higher during the influenza season. However, resolution of new nodules and number of matched cancers appears comparable in both winter and summer. Hence, this study does not clarify whether seasonal respiratory illnesses are directly related to this increased incidence. Further investigation into seasonal incidence and outcome of baseline nodules in this population could help elucidate the cause of the higher incidence of nodules during the influenza months.
| Original language | English |
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| DOIs | |
| Publication status | Published - 2022 |
| Event | World Conference on Lung Cancer - Vienna, Austria Duration: 6-Aug-2022 → 9-Aug-2022 |
Conference
| Conference | World Conference on Lung Cancer |
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| Period | 06/08/2022 → 09/08/2022 |