RT Journal Article SR Electronic T1 Who is at risk of lung nodules on low-dose CT in a Western country? A population-based approach JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 2301736 DO 10.1183/13993003.01736-2023 A1 Cai, Jiali A1 Vonder, Marleen A1 Du, Yihui A1 Pelgrim, Gert Jan A1 Rook, Mieneke A1 Kramer, Gerdien A1 Groen, Harry J. M. A1 Vliegenthart, Rozemarijn A1 de Bock, Geertruida H. YR 2024 UL https://publications.ersnet.org//content/early/2024/04/18/13993003.01736-2023.abstract AB Background This population-based study aimed to identify the risk factors for lung nodules in a Western European general population.Methods We quantified the presence or absence of lung nodules among 12 055 participants of the Dutch population-based ImaLife (Imaging in Lifelines) study (≥45 years) who underwent low-dose chest computed tomography. Outcomes included the presence of 1) at least one solid lung nodule (volume≥30 mm3) and 2) a clinically relevant lung nodule (volume≥100 mm3). Fully adjusted multivariable logistic regression models were applied overall and stratified by smoking status to identify independent risk factors for nodules presence.Results Among the 12 055 participants (44.1% men; median age 60 years; 39.9% never smokers; 98.7% Caucasian), we found lung nodules in 41.8% (5045 out of 12 055) and clinically relevant nodules in 11.4% (1377 out of 12 055); the corresponding figures among never smokers were 38.8% and 9.5%. Factors independently associated with increased odds of having any lung nodule included male-sex, older-age, low-educational level, former smoking, asbestos exposure, and chronic obstructive pulmonary disease. Among never smokers, a family history of lung cancer increased the odds of both lung nodules and clinically relevant nodules. Among former and current smokers, low educational level was positively associated with lung nodules, whereas being overweight was negatively associated. Among current smokers, asbestos exposure and low physical activity were associated with clinically relevant nodules.Conclusions The study provides a large-scale evaluation of lung nodules and associated risk factors in a Western European general population: lung nodules and clinically relevant nodules were prevalent, and never smokers with a family history of lung cancer were a non-negligible group.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: M.Vonder is a researcher for Institute for Diagnostic Accuracy, Groningen. The remaining authors declare no conflict of interest.