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One or more lung nodules can be an incidental finding found in up to 0.2% of chest X-rays [3] and around 1% of CT scans. [ 4 ] The nodule most commonly represents a benign tumor such as a granuloma or hamartoma , but in around 20% of cases it represents a malignant cancer , [ 4 ] especially in older adults and smokers .
In 1996, results were published of a study of 1369 subjects screened in Japan that revealed that 73% of lung cancers that were missed by chest x-ray were detectable by CT scan. [19] Among the earliest United States-based clinical trials was the Early Lung Cancer Action Project (ELCAP), which published its results in 1999. [ 20 ]
A 2022 report from the American Lung Association indicated that only 5.8% of Americans had been screened for lung cancer and that in some states, rates were as low as 1%.
As of October 2010, 354 people in the CT scan group had died from lung cancer, versus 442 people in the X-ray group; in other words, deaths in the CT scan group of patients were 20.3% lower than in the X-ray group. [10] The study's review board concluded that this difference was statistically significant and recommended terminating the study. [10]
High-resolution CT image showing ground-glass opacities in the periphery of both lungs in a patient with COVID-19 (red arrows). The adjacent normal lung tissue with lower attenuation appears as darker areas. Ground-glass opacity (GGO) is a finding seen on chest x-ray (radiograph) or computed tomography (CT) imaging of the lungs.
CT scans can be performed with different settings for lower exposure in children with most manufacturers of CT scans as of 2007 having this function built in. [170] Furthermore, certain conditions can require children to be exposed to multiple CT scans. [148] Current recommendations are to inform patients of the risks of CT scanning. [171]