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Pulmonary Nodule Prevalence at CT in Middle-Aged Participants from the Swedish CArdioPulmonary bioImage Study (SCAPIS)

Sörensen, Karen ; Johnsson, Åse A ; Liv, Per ; Bacsovics Brolin, Elin ; Blomberg, Anders ; Bolejko, Anetta LU orcid ; Carlhäll, Carl-Johan ; Cederlund, Kerstin ; Emilsson, Össur Ingi and Engvall, Jan E , et al. (2026) In Radiology 318(1).
Abstract

Background Pulmonary nodules (PNs) are clinically challenging because differentiation between benign and malignant PNs is not possible at CT detection; recurring CT examinations and invasive procedures are often required in PN follow-up. Purpose To investigate PN prevalence in a middle-aged population and the risk factors associated with these nodules. Materials and Methods In this secondary analysis of the cross-sectional population-based Swedish CArdioPulmonary bioImage Study (known as SCAPIS, from November 2013 to November 2018), participants aged 50-64 years with chest CT data were analyzed. Risk factors such as smoking history, occupational exposure (vapor, dust, gas, and fumes), and lung diseases were derived from comprehensive... (More)

Background Pulmonary nodules (PNs) are clinically challenging because differentiation between benign and malignant PNs is not possible at CT detection; recurring CT examinations and invasive procedures are often required in PN follow-up. Purpose To investigate PN prevalence in a middle-aged population and the risk factors associated with these nodules. Materials and Methods In this secondary analysis of the cross-sectional population-based Swedish CArdioPulmonary bioImage Study (known as SCAPIS, from November 2013 to November 2018), participants aged 50-64 years with chest CT data were analyzed. Risk factors such as smoking history, occupational exposure (vapor, dust, gas, and fumes), and lung diseases were derived from comprehensive questionnaires. Robust Poisson regression was used to evaluate associations, adjusted for age and sex, between potential risk factors and the binary outcome of nodule presence or absence. Prevalence ratios (PRs), adjusted for age and sex, and 95% CIs were estimated. Results Among 29 574 participants (median age, 57.4 years; IQR, 53.7-61.2 years; 15 168 women), solid nodules sized 100-300 mm3, part-solid, and ground-glass nodules were found in 1420 (4.8%), 199 (0.7%), and 430 (1.5%), respectively. The prevalence of solid nodules among participants who never, formerly, and currently smoked was 32.5% (4713 of 14 515), 34.5% (3602 of 10 437), and 37.9% (1381 of 3644), respectively. Solid nodules sized 100-300 mm3 were associated with current smoking (PR, 1.38; 95% CI: 1.19, 1.60), chronic obstructive pulmonary disease (PR, 1.72; 95% CI: 1.17, 2.53), occupational exposure (PR, 1.31; 95% CI: 1.11, 1.54), emphysema (PR, 1.56; 95% CI: 1.31, 1.86), reticulation (PR, 1.96; 95% CI: 1.47, 2.61), and bronchiectasis (PR, 2.03; 95% CI: 1.64, 2.50). In participants who had never smoked, associations were found between solid nodules at least 100 mm3 and reticulation (PR, 2.28; 95% CI: 1.55, 3.36), reported lung disease other than asthma or chronic obstructive pulmonary disease (PR, 2.26; 95% CI: 1.49, 3.43), and bronchiectasis (PR, 2.17; 95% CI: 1.60, 2.94). Conclusion PN prevalence was approximately the same in a middle-aged population regardless of smoking history. In participants who had never smoked, nodules were linked to reported lung disease, reticulation, and bronchiectasis. © The Author(s) 2026. Published by the Radiological Society of North America under a CC BY 4.0 license. Supplemental material is available for this article.

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keywords
Humans, Middle Aged, Male, Female, Sweden/epidemiology, Prevalence, Tomography, X-Ray Computed/methods, Cross-Sectional Studies, Risk Factors, Solitary Pulmonary Nodule/diagnostic imaging, Multiple Pulmonary Nodules/diagnostic imaging, Lung Neoplasms/diagnostic imaging
in
Radiology
volume
318
issue
1
article number
e251917
publisher
Radiological Society of North America
external identifiers
  • pmid:41591243
  • scopus:105028661372
ISSN
1527-1315
DOI
10.1148/radiol.251917
language
English
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yes
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c8a2dcb8-0f86-4502-9aaa-9a03173d20fd
date added to LUP
2026-02-16 12:46:18
date last changed
2026-02-17 04:01:34
@article{c8a2dcb8-0f86-4502-9aaa-9a03173d20fd,
  abstract     = {{<p>Background Pulmonary nodules (PNs) are clinically challenging because differentiation between benign and malignant PNs is not possible at CT detection; recurring CT examinations and invasive procedures are often required in PN follow-up. Purpose To investigate PN prevalence in a middle-aged population and the risk factors associated with these nodules. Materials and Methods In this secondary analysis of the cross-sectional population-based Swedish CArdioPulmonary bioImage Study (known as SCAPIS, from November 2013 to November 2018), participants aged 50-64 years with chest CT data were analyzed. Risk factors such as smoking history, occupational exposure (vapor, dust, gas, and fumes), and lung diseases were derived from comprehensive questionnaires. Robust Poisson regression was used to evaluate associations, adjusted for age and sex, between potential risk factors and the binary outcome of nodule presence or absence. Prevalence ratios (PRs), adjusted for age and sex, and 95% CIs were estimated. Results Among 29 574 participants (median age, 57.4 years; IQR, 53.7-61.2 years; 15 168 women), solid nodules sized 100-300 mm3, part-solid, and ground-glass nodules were found in 1420 (4.8%), 199 (0.7%), and 430 (1.5%), respectively. The prevalence of solid nodules among participants who never, formerly, and currently smoked was 32.5% (4713 of 14 515), 34.5% (3602 of 10 437), and 37.9% (1381 of 3644), respectively. Solid nodules sized 100-300 mm3 were associated with current smoking (PR, 1.38; 95% CI: 1.19, 1.60), chronic obstructive pulmonary disease (PR, 1.72; 95% CI: 1.17, 2.53), occupational exposure (PR, 1.31; 95% CI: 1.11, 1.54), emphysema (PR, 1.56; 95% CI: 1.31, 1.86), reticulation (PR, 1.96; 95% CI: 1.47, 2.61), and bronchiectasis (PR, 2.03; 95% CI: 1.64, 2.50). In participants who had never smoked, associations were found between solid nodules at least 100 mm3 and reticulation (PR, 2.28; 95% CI: 1.55, 3.36), reported lung disease other than asthma or chronic obstructive pulmonary disease (PR, 2.26; 95% CI: 1.49, 3.43), and bronchiectasis (PR, 2.17; 95% CI: 1.60, 2.94). Conclusion PN prevalence was approximately the same in a middle-aged population regardless of smoking history. In participants who had never smoked, nodules were linked to reported lung disease, reticulation, and bronchiectasis. © The Author(s) 2026. Published by the Radiological Society of North America under a CC BY 4.0 license. Supplemental material is available for this article.</p>}},
  author       = {{Sörensen, Karen and Johnsson, Åse A and Liv, Per and Bacsovics Brolin, Elin and Blomberg, Anders and Bolejko, Anetta and Carlhäll, Carl-Johan and Cederlund, Kerstin and Emilsson, Össur Ingi and Engvall, Jan E and Hansen, Tomas and Johansson, Mikael and Khalil, Mohammad and Karimi, Reza and Landenhed-Smith, Maya and Malinovschi, Andrei and Sköld, C Magnus and Swahn, Eva and Torén, Kjell and Vikgren, Jenny and Zaigham, Suneela and Östgren, Carl Johan and Behndig, Annelie F}},
  issn         = {{1527-1315}},
  keywords     = {{Humans; Middle Aged; Male; Female; Sweden/epidemiology; Prevalence; Tomography, X-Ray Computed/methods; Cross-Sectional Studies; Risk Factors; Solitary Pulmonary Nodule/diagnostic imaging; Multiple Pulmonary Nodules/diagnostic imaging; Lung Neoplasms/diagnostic imaging}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Radiological Society of North America}},
  series       = {{Radiology}},
  title        = {{Pulmonary Nodule Prevalence at CT in Middle-Aged Participants from the Swedish CArdioPulmonary bioImage Study (SCAPIS)}},
  url          = {{http://dx.doi.org/10.1148/radiol.251917}},
  doi          = {{10.1148/radiol.251917}},
  volume       = {{318}},
  year         = {{2026}},
}