Small lung nodules found in testing not necessarily cancerous, expert says

Strict COVID-19 prevention, control and screening measures in hospitals across China may have helped curb potential deaths caused by lung cancer, a senior expert in lung diseases said.

On the other hand, people identified as having small nodules in their lungs during COVID-19 screening should not worry excessively as most such nodules will not develop into cancer, said Zhi Xiuyi, vice-president of the Chinese Association on Tobacco Control.

“In many places, it has become mandatory for all patients to undergo a computed tomography test on their lungs to rule out novel coronavirus infection before they are hospitalized,” said Zhi, also director of Capital Medical University’s Lung Cancer Center.

“As a result, nodules not related to COVID-19 have been found in the lungs of millions of patients across the country.”

As a key measure to control the spread of novel coronavirus, mandatory nucleic acid tests for the virus have covered key groups in China since June, including healthcare workers and patients about to be hospitalized, according to the National Health Commission.

Additionally, many hospitals have also requested patients undergo a CT scan on their lungs to ensure they are not carrying the virus before hospitalization to prevent cross-infection. Many COVID19 patients can develop pneumonia and any erosion of their lungs can be detected in CT images.

Lung cancer, a major health threat for Chinese people, starts with small lung nodules in many cases, which can be most effectively identified by CT scanning.

“We have been appealing to the public, especially higher-risk groups, to pay more attention to the prevention and treatment of lung cancer in recent years, including receiving CT scans, but only a very limited number of people would receive such tests voluntarily,” Zhi said. “Due to mandatory COVID-19 screening at hospitals, the number of people receiving lung scans has greatly increased in many places, resulting in a significant rise in the number of patients identified with lung nodules.”

As most people will seek diagnosis and treatment after such nodules are detected, those who are likely to have lung cancer will have a better chance of getting early treatment and surviving, Zhi said.

With the population aging and lifestyles changing, the number of cancer patients has been rising in China.

Every year, 4.3 million people are newly diagnosed with various cancers in the country, with lung cancer the most common one, according to the National Cancer Center. Like many other cancers, lung cancer can be cured if detected at early stages, with five-year survival rates as high as 90 percent.

With lung nodules being found in so many patients, many of them worry that they may have lung cancer, Zhi said.

“There is no need to panic over such lung nodules that were identified unintentionally,” he said. “Some research has shown that more than 95 percent of all small lung nodules identified for the first time by CT scans are benign.

“Many nodules develop naturally as the body ages and may have existed for many years, just like wrinkles develop on the face or hair turns white. So when a person is identified with a small nodule in the lungs for the first time, it is not necessary for them to immediately receive surgery to remove it.”