Lung removal often unneeded for "incidentalomas"

NEW YORK (Reuters Health) - Lung cancers that are detected during X-ray for other conditions, so-called "incidentalomas," tend to be smaller and less likely to require removal of a lung, according to a research team at the University of California-San Francisco.

Incidental identification of lung tumors will be more common as imaging for heart disease, abdominal pain, and other conditions, increases, the investigators note.

As yet, however, screening is not recommended for lung cancer, which may be one reason why lung cancer survival is as low now as it was 30 years ago, whereas survival from other cancers has improved because of routine screening, Dr. Dan J. Raz and his associates note in the Journal of Thoracic Oncology.

Raz and his team identified 274 patients who underwent surgery for lung cancer at their hospital between 1999 and 2004. Of these, 100 had incidentalomas.

"Not surprisingly," the investigators write, "patients with incidentally detected lung cancer had smaller cancers and earlier-stage disease." In fact, half of all patients with early disease had lung cancer detected by chance.

As noted, incidental tumors were less likely to require lung removal, which carries greater risks than simply removing a portion or "lobe" of the lung.

No significant difference in survival was seen for patients with incidentally detected versus regularly detected cancers. However, the researches suggest that this may have simply been because not enough patients were studied.

SOURCE: Journal of Thoracic Oncology, February 2007.