Nearly 90% of significant incidental findings on lung cancer screenings are considered reportable

Recent data from the National Lung Screening Trial indicate that over 30% of low dose computed tomography (LDCT) screenings for lung cancer reveal significant incidental findings requiring attention from radiologists.

In a case series examining 26,455 participants undergoing CT lung cancer screenings, the majority of screenings with significant incidental findings (SIFs) displayed at least one abnormality that warranted reporting to the patient’s referring provider. These findings were published in JAMA Internal Medicine on May 8.

Researchers Ilana F. Gareen, PhD, Roee Gutman, PhD, and JoRean Sicks, MS, affiliated with the Center for Statistical Sciences at Brown University School of Public Health, highlighted that while incidental findings on LDCT screenings are common, less is known about the frequency of reportable SIFs.

The study analyzed data from the National Lung Screening Trial conducted across 33 academic institutions between 2002 and 2009, encompassing over 75,000 LDCT screenings. Despite the common occurrence of SIFs in 33.8% of participants, a striking 89% of these findings were deemed reportable, indicating a potential need for more stringent reporting guidelines concerning incidental discoveries.

Lung cancer remains one of the most prevalent and deadly forms of cancer worldwide, demanding continued attention for improved early detection and treatment strategies.

The prevalent reportable SIFs included emphysema (8,677 cases), coronary artery calcium (2,432 cases), and masses (1,493 cases) in various organs like the kidney, liver, adrenal glands, and breast. Additionally, these reportable SIFs were frequently associated with positive findings in LDCT screenings.

The authors underscored that reportable SIFs often necessitate further examinations and possible treatment, emphasizing the need for consistent reporting aligned with established guidelines to minimize costs for patients, clinicians, and the healthcare system.

They recommended future research focus on standardizing the reporting of significant incidental findings to streamline procedures and enhance patient care.