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Free Content Pulmonary nodules detected by thoracic computed tomography scan after exposure to asbestos: diagnostic significance

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OBJECTIVE: To analyse the relationship between pulmonary nodules detected by radiologists using computed tomography and cumulative exposure to asbestos or asbestos-related pleuro-pulmonary diseases in 5662 asbestos-exposed subjects, and the relationship between pulmonary nodules and thoracic cancer, to determine whether a specific surveillance strategy based on cumulative asbestos exposure should be adopted.

DESIGN: Standardised incidence and mortality ratios (SIR) for lung cancer and pleural mesothelioma were calculated in patients with and without mention of pulmonary nodules and compared using comparative morbidity figures.

RESULTS: A significant excess incidence of primary lung cancer and pleural mesothelioma was observed among subjects presenting with pulmonary nodule(s) (SIR respectively 1.95, 95%CI 1.22–2.95, and 11.88, 95%CI 3.20–30.41). However, there was no significant relationship between pulmonary nodules mentioned by radiologists and cumulative asbestos exposure or between pulmonary nodules and the presence of asbestosrelated benign diseases.

CONCLUSIONS: This study confirms the expected excess prevalence of lung cancer in subjects presenting with pulmonary nodules according to the radiologist's report, and shows the absence of relationship between the presence of nodules and level of cumulative asbestos exposure. Our study therefore offers no argument in favour of specific surveillance modalities based on estimated cumulative asbestos exposure.
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Keywords: ASBESTOS; CT SCAN; LUNG CANCER; PULMONARY NODULE; SCREENING

Document Type: Short Communication

Affiliations: 1: Cancers and Populations, Faculty of Medicine, ERI3 Institut National de la Santé et de la Recherche Médicale (INSERM), Caen University Hospital, Caen; Occupational Health Department, Caen University Hospital, Caen, France 2: Unité 954, Faculty of Medicine, INSERM, Nancy University Hospital, Nancy, France 3: Cancers and Populations, Faculty of Medicine, ERI3 Institut National de la Santé et de la Recherche Médicale (INSERM), Caen University Hospital, Caen, France 4: Assistance Publique/Hôpitaux de Paris, Occupational Diseases Department, Hôpital Raymond Poincaré, Garches, France 5: Occupational Diseases Department, Laboratoire Santé Travail Environnement, University Hospital, Bordeaux, France 6: Occupational Health Department, Caen University Hospital, Caen, France 7: Occupational Diseases Department, University Hospital, Rouen, France 8: Unité 855, INSERM, Université Bordeaux 2, Bordeaux, France 9: Échelon Régional du Service Médical, Rhône-Alpes, Regional Security Insurance, Lyons, France 10: Unité 955, INSERM, Créteil; Service de Pneumologie et Pathologie Professionnelle, Centre Hospitalier Intercommunal, Créteil, France

Publication date: December 1, 2011

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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