Please use this identifier to cite or link to this item: https://hdl.handle.net/11000/30515

Differences in the clinical management of women and men after detection of a solitary pulmonary nodule in clinical practice

Title:
Differences in the clinical management of women and men after detection of a solitary pulmonary nodule in clinical practice
Authors:
Chilet Rosell, Elisa  
Parker, Lucy Anne  
Hernández-Aguado, Ildefonso  
Pastor-Valero, Maria  
Vilar, José
González-Álvarez, Isabel
Salinas Serrano, Jose Maria  
Lorente-Fernández, Fermina
Domingo, M. Luisa
Lumbreras, Blanca  
Editor:
Springer
Department:
Departamentos de la UMH::Salud Pública, Historia de la Ciencia y Ginecología
Issue Date:
2020-03
URI:
https://hdl.handle.net/11000/30515
Abstract:
Objectives To explore differences in the clinical management of men and women in the 5 years after detecting a solitary pulmonary nodule (SPN) by chest radiograph or CT in routine clinical practice. Methods We followed up 545 men and 347 women with an SPN detected by chest radiograph or CT in a retrospective cohort of 25,422 individuals undergoing routine thoracic imaging in 2010–2011.We compared the frequency of each management strategy (no further test, immediate intervention or follow up) according to sex by means of chi-squared.We estimated the relative risk of women versus men of having been followed up instead of an immediate intervention using multivariate logistic regression. We compared by sex the time between detection of the nodule and lung cancer diagnosis, the time between diagnosis and death by means of Mann-Whitney U test and the cumulative effective dose of radiation in each management strategy by means of t test. Results Women were more likely than men to have follow-up rather than immediate intervention (aRR = 1.8, CI 1.3–2.7, p = 0.002), particularly in those who underwent CT (aRR = 4.2, CI 1.9–9.3, p < 0.001). The median time between SPN detection and lung cancer diagnosis was higher in women (4.2 months, interquartile range (IQR) 5.1) than in men (1.5 months, IQR 16.2). The mean cumulative effective dose was 21.3 mSv, 19.4 mSv in men and 23.9mv in women (p = 0.023). Conclusions Our results could reflect decisions based on a greater suspicion of lung cancer in men. The incidental detection of SPNs is increasing, and it is necessary to establish clear strategies aimed to reduce variability in their management according to patient’s sex.
Keywords/Subjects:
Lung cancer
Solitary pulmonary nodule
Sex differences
Knowledge area:
CDU: Ciencias aplicadas: Medicina
Type of document:
application/pdf
Access rights:
info:eu-repo/semantics/openAccess
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
DOI:
https://doi.org/10.1007/s00330-020-06791-z
Appears in Collections:
Artículos Salud Pública, Historia de la Ciencia y Ginecología



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