Table 2

Pulmonary Nodule Characteristics and Risks Associated With Exams and Interventions

VariableBase Case EstimateRangeRef. #
Incidental findings
 Prevalence of lung nodules
  Nonsmokers*0.003Not varied27
  Lung field area visualized on CCTA0.40Not varied26
 Lung nodule characteristics
  Diameter of small nodules (≤8 mm)2–8 mm28
  Diameter of large nodules (>8 mm)>8 mm–2 cm28
  Portion of nodules that are small0.6Not varied27,28
 Probability of growth in first yr
  Benign nodules0.058Not varied32
  Malignant nodules0.96Not varied32,34
 Probability of growth in subsequent yrs
  Benign nodules0.058Not varied32
  Malignant nodules1Not varied32,34
 FDG-PET test characteristics
  Sensitivity for malignant nodules0.94Not varied33
  Specificity for malignant nodules0.83Not varied33
Interventional mortality risks
 Stress testing0.00005Not varied35
 CCTA (and CT exams in general)0.0000090.0008–0.00212,36
 Invasive coronary angiography0.001Not varied51
 Percutaneous coronary intervention0.011Not varied37
 Coronary artery bypass graft surgery0.0266Not varied38
 Video-assisted thoracic surgery0.005Not varied32
 Lobectomy0.0137Not varied39

FDG-PET = 18-fluorodeoxyglucose positron emission tomography.

  • * Estimated by generalizing Early Lung Cancer Action Project data and assuming overall nodule prevalence is a linear combination of nodules in smokers and nonsmokers;

  • varied to simulate attributable risk of cancer mortality from coronary computed tomography angiography (CCTA) radiation.