Subsolid lung nodules pose greater cancer risk to women than men

November 24, 2015

CHICAGO - Women with a certain type of lung nodule visible on lung cancer screening CT exams face a higher risk of lung cancer than men with similar nodules, according to a new study being presented next week at the annual meeting of the Radiological Society of North America (RSNA).

Lung nodules are small masses of tissue in the lungs that are classified as solid or subsolid based on their appearance on CT. Solid nodules are dense, and they obscure adjacent tissue, while subsolid nodules are divided into two different types: part solid (nodules with both a solid component and a ground-glass, or hazy area), and pure ground glass, which are devoid of solid elements. Nodule consistency is considered an indicator of lung cancer risk, with part solid nodules being most strongly associated with lung cancer in the screening setting.

"We know there are differences in cancer risk among different lung nodule consistencies, but we were unaware of any published reports that looked at the differences in lung cancer risk for nodule subtypes between women and men," said study lead author Phillip Boiselle, M.D., from Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, Mass.

For the new study, Dr. Boiselle and colleagues reviewed CT scans from the National Lung Screening Trial (NLST), a large, randomized control study that demonstrated the value of CT screening in reducing lung cancer mortality. The NLST included more than 40 percent women, giving the research team a rare opportunity to look for statistically significant differences in lung nodules and lung cancer between the sexes.

The researchers characterized all CT-detected nodules measuring 4 to 30 millimeters by consistency using the NLST database and calculated the relative risk of developing a lung cancer for each nodule consistency subtype.

Out of 26,455 participants, 9,994, or 37.8 percent, had a positive screen at one or more points during the trial. Women with ground-glass nodules had a significantly higher relative risk of lung cancer than men with the same type of nodules, and a similar trend was observed for part-solid nodules. In contrast, the relative risk of lung cancer for solid nodules was comparable for both sexes.

Part-solid nodules had the highest predictive value of cancer in both sexes, whereas solid nodules had the lowest predictive value in women and ground glass nodules had the lowest predictive value in men.

"The main difference we found was that women were 50 percent more likely than men to have ground-glass nodules and, when these nodules were present, women had a substantially higher risk of developing lung cancer," Dr. Boiselle said.

Current lung cancer screening guidelines do not take into account gender differences when managing nodules of different consistencies. While more research is needed before changes are made to clinical practice, the results suggest that women with ground glass nodules may need closer follow-up than men.

"By looking at the rate at which lung cancers grow on serial CT scans, we can develop a better understanding of how often to obtain follow-up CT scans in men and women," Dr. Boiselle said.

The researchers plan to continue studying the NLST data to further understand the significance of these cancers, especially with respect to their influence on lung cancer mortality.
-end-
Co-authors on the study are Fenghai Duan, Ph.D., Stavroula Chysanthopoulou, Ph.D., Sarah DeMello, M.S., Denise R. Aberle, M.D., and Caroline Chiles, M.D.

Note: Copies of RSNA 2015 news releases and electronic images will be available online at RSNA.org/press15 beginning Monday, Nov. 30.

RSNA is an association of more than 54,000 radiologists, radiation oncologists, medical physicists and related scientists, promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)

Editor's note: The data in these releases may differ from those in the published abstract and those actually presented at the meeting, as researchers continue to update their data right up until the meeting. To ensure you are using the most up-to-date information, please call the RSNA Newsroom at 1-312-791-6610.

For patient-friendly information on CT screening for lung cancer, visit RadiologyInfo.org.

Radiological Society of North America

Related Lung Cancer Articles from Brightsurf:

State-level lung cancer screening rates not aligned with lung cancer burden in the US
A new study reports that state-level lung cancer screening rates were not aligned with lung cancer burden.

The lung microbiome may affect lung cancer pathogenesis and prognosis
Enrichment of the lungs with oral commensal microbes was associated with advanced stage disease, worse prognosis, and tumor progression in patients with lung cancer, according to results from a study published in Cancer Discovery, a journal of the American Association for Cancer Research.

New analysis finds lung cancer screening reduces rates of lung cancer-specific death
Low-dose CT screening methods may prevent one death per 250 at-risk adults screened, according to a meta-analysis of eight randomized controlled clinical trials of lung cancer screening.

'Social smokers' face disproportionate risk of death from lung disease and lung cancer
'Social smokers' are more than twice as likely to die of lung disease and more than eight times as likely to die of lung cancer than non-smokers, according to research presented at the European Respiratory Society International Congress.

Lung cancer therapy may improve outcomes of metastatic brain cancer
A medication commonly used to treat non-small cell lung cancer that has spread, or metastasized, may have benefits for patients with metastatic brain cancers, suggests a new review and analysis led by researchers at St.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Lung transplant patients face elevated lung cancer risk
In an American Journal of Transplantation study, lung cancer risk was increased after lung transplantation, especially in the native (non-transplanted) lung of single lung transplant recipients.

Proposed cancer treatment may boost lung cancer stem cells, study warns
Epigenetic therapies -- targeting enzymes that alter what genes are turned on or off in a cell -- are of growing interest in the cancer field as a way of making a cancer less aggressive or less malignant.

Are you at risk for lung cancer?
This question isn't only for people who've smoked a lot.

Read More: Lung Cancer News and Lung Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.