Lung Cancer Screening Program

Should You Be Concerned About Lung Nodules?

If your doctor discovers that you have a lung nodule, you might be alarmed. After all, some lung nodules can be cancerous. However, according to pulmonologist James Finigan, MD, learning about a lung nodule isn’t a reason to panic. “They're super common,” said Dr. Finigan. “And many times they’re benign. However, it’s always important for us to check. Most nodules are not cancerous but will get some kind of follow-up. And the reason is that a benign nodule often looks identical to a small lung cancer, so it’s important for us to investigate.”

What Is a Lung Nodule?

A lung nodule is a small mass of tissue. Typically, nodules are smaller than three centimeters. “If you think of the lungs as sponges — filled mostly with air — if you were to press down on the sponge and feel a tiny bead halfway through, that’s very similar to how a nodule is situated in a lung,” said Dr. Finigan.

In general, lung nodules can be caused by irritants that you breathe in, cancer, infections, inflammation or scar tissue. Lung nodules can be benign (noncancerous) or malignant (cancerous). More than 90% of lung nodules are not cancerous.

It’s important to note that benign lung nodules don’t turn cancerous. Instead, lung nodules resemble small cancerous growths in the lungs, which is why doctors pay close attention to them. “When we spot a lung nodule, we also take the individual into consideration,” said Dr. Finigan. “For instance, people who are young, healthy nonsmokers with nodules are unlikely to have lung cancer.” Most of the time, lung nodules turn out to be benign. However, depending on your individual risks — if you’re a longtime smoker for instance — your doctor might want to do a deeper investigation. Other times, lung nodules will be monitored to see if they grow or change over time. “The goal is always to catch lung cancer at a very early stage,” said Dr. Finigan.

Benign Lung Nodules vs. Cancer

So how do doctors distinguish between lung nodules and small cancerous growths? According to Dr. Finigan, there are a variety of tools and methods that can provide insight. For instance, after detecting a lung nodule from a routine X-ray, a doctor may recommend follow-up imaging, including a computer tomography (CT) scan[MC1] , which can provide more detailed images of the inside of the lungs. If the follow-up scan shows that the lung nodule isn’t changing, then it’s most likely benign. “Benign lung nodules don’t cause problems for the most part,” said Dr. Finigan. “If we see a lung nodule that starts to grow, or if it changes in appearance, that’s when we’ll start doing biopsies and further imaging to check for signs of cancer.”

Of course, the initial size of the lung nodule also can alert doctors to potential risk. “Larger lung nodules are more likely to be cancerous than smaller ones,” said. Dr. Finigan. The size of cancerous lung growths also tells doctors a lot about how aggressive the treatment plan should be. Most of the time, when a nodule is less than 1.5cm in diameter, the cancer is more treatable.

“Lung cancer is the number one killer of men and women in the United States. That’s why, even though most nodules are benign, we want to pay attention to them and then really attack the cancer as soon as we detect it,” said Dr. Finigan.

Lung cancer caught early is highly treatable and curable. Screening for Lung Nodules

Lung nodules are typically found in two ways. Sometimes, doctors will incidentally detect lung nodules when you’re getting a CT scan of your chest for another reason. However, for people with a history of smoking, doctors recommend getting a screening of your lungs.

At National Jewish Health, we highly recommends lung cancer screening for people who:

Are 50-80 years old
Are current or former smokers, with at least 20-pack years of smoking. Pack-years are determined by the number of cigarette packs smoked per day multiplied by the number of years you smoked.

Take our quiz to learn if you qualify for a low-dose CT screening at no cost through your insurance provider or Medicare.

You also can learn more about our lung cancer screening program here.