- Research Article
- 10.1016/j.lungcan.2026.109352
Volume and location of screen-detected lung nodules associated with lung cancer within two-year follow-up: Post hoc analysis from the UK Lung Cancer Screening (UKLS) trial.
- May 01, 2026
- Lung cancer (Amsterdam, Netherlands)
- Oke Dimas Asmara + 11 more +11
Follow-up of radiologically suspicious lung nodules from screening programs remains complex and unstandardized. This study analyses distribution and characteristics of solid and part-solid non-calcified nodules ≥100mm3 and non-solid nodules ≥8mm detected at baseline in the UK Lung cancer Screening (UKLS) trial, with insights into their relationship to screen-detected lung cancers. UKLS participants with baseline indeterminate and positive lung nodules were included. Nodule location was categorized by lobe and by attachment: intraparenchymal, juxta pleural or pleural-based. Solid and part-solid were classified based on semi-automated volume: 100-300mm3 and ≥300mm3, and non-solid nodules based on diameter ≥8mm. This measurement approach aligns with UKLS protocol and the British Thoracic Society (BTS) guideline. Their relationship to screen-detected lung cancer was based on histological outcomes after a 2-year follow-up period. 279 UKLS participants with 373 solid or part-solid lung nodules ≥100mm3 and 57 participants with 62 nonsolid nodules ≥8mm were included. Among solid and part-solid nodules, 233 were 100-300mm3, with 39.5% in upper lobes and 72.5% intraparenchymal; 140 nodules were ≥300mm3, with 51.4% in upper lobes and 53.6% intraparenchymal. Nodules ≥300mm3 group were more likely to be in the upper lobes (OR 1.97 [95% CI 1.12-3.48]). Within 2years, 34 solid or part-solid nodules were diagnosed as lung cancer, yielding a 2-year cancer probability of 9.1% (95% CI 6.6-12.5). The 2-year lung cancer probability was higher in nodules ≥300mm3 (RR 18.1, 95% CI 5.6-58.4; p<0.001) and in upper lobe nodules (RR 2.7, 95% CI 1.3-5.5; p=0.009). Solid and part-solid nodules with volume ≥300mm3 were more often found in the upper lobes and were associated with a higher probability of lung cancer within a two-year follow-up period.
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