The determinants of lung cancer after detecting a solitary pulmonary nodule are different in men and women, for both chest radiograph and CT
Por:
Chilet-Rosell E, Parker LA, Hernández-Aguado I, Pastor-Valero M, Vilar J, González-Álvarez I, Salinas-Serrano JM, Lorente-Fernández F, Domingo ML and Lumbreras B
Publicada:
11 sep 2019
Ahead of Print:
11 sep 2019
Categoría:
Multidisciplinary
Resumen:
Objectives
To determine the factors associated with lung cancer diagnosis and mortality after detecting a solitary pulmonary nodule (SPN) in routine clinical practice, in men and in women for both chest radiograph and CT.
Materials and methods
A 5-year follow-up of a retrospective cohort of of 25,422 (12,594 men, 12,827 women) patients aged.35 years referred for chest radiograph or CT in two hospitals in Spain (2010-2011). SPN were detected in 893 (546 men, 347 women) patients. We estimated the cumulative incidence of lung cancer at 5-years, the association of patient and nodule characteristics with SPN malignancy using Poisson logistic regression, stratifying by sex and type of imaging test. We calculated lung cancer specific mortality rate by sex and SPN detection and hazard rates by cox regression.
Results
133 (14.9%) out of 893 patients with an SPN and 505 (2.06%) of the 24,529 patients without SPN were diagnosed with lung cancer. Median diameter of SPN in women who developed cancer was larger than in men. Men who had a chest radiograph were more likely to develop a lung cancer if the nodule was in the upper-lobes, which was not the case for women. In patients with an SPN, smoking increased the risk of lung cancer among men (chest radiograph: RR = 11.3, 95%CI 1.5-83.3; CT: RR = 7.5, 95%CI 2.2, 26.0) but smoking was not significantly associated with lung cancer diagnosis or mortality among women with an SPN. The relative risk of lung cancer diagnosis in women with SPN versus those without was much higher compared to men (13.7; 95%CI 9.2, 20.4 versus 6.2; 95%CI 4.9,7.9).
Conclusion
The factors associated with SPN malignancy and 5-year lung cancer mortality were different among men and women, especially regarding smoking history and SPN characteristics, where we observed a relatively high rate of lung cancer diagnosis among female nonsmokers.
Filiaciones:
Chilet-Rosell E:
Public Health, History of Science and Gynaecology Department, Miguel Hernández University, Alicante, Spain
CIBER en Epidemiología y Salud Pública, Madrid, Spain
Parker LA:
Public Health, History of Science and Gynaecology Department, Miguel Hernández University, Alicante, Spain
CIBER en Epidemiología y Salud Pública, Madrid, Spain
Hernández-Aguado I:
Public Health, History of Science and Gynaecology Department, Miguel Hernández University, Alicante, Spain
CIBER en Epidemiología y Salud Pública, Madrid, Spain
Pastor-Valero M:
Public Health, History of Science and Gynaecology Department, Miguel Hernández University, Alicante, Spain
CIBER en Epidemiología y Salud Pública, Madrid, Spain
:
Radiodiagnostic Department, Peset Hospital, Valencia, Spain
:
Radiodiagnostic Department, San Juan Hospital, San Juan de Alicante, Spain
:
Computer Department, San Juan Hospital, San Juan de Alicante, Spain
:
Radiodiagnostic Department, San Juan Hospital, San Juan de Alicante, Spain
:
Radiodiagnostic Department, Peset Hospital, Valencia, Spain
Lumbreras B:
Public Health, History of Science and Gynaecology Department, Miguel Hernández University, Alicante, Spain
CIBER en Epidemiología y Salud Pública, Madrid, Spain
Green Submitted, Green Published, gold
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