Patients' Knowledge, Beliefs, and Distress Associated with Detection and Evaluation of Incidental Pulmonary Nodules for Cancer: Results from a Multicenter Survey

The goal of this multicenter survey was to determine the psychological and social impact of incidental pulmonary nodule detection. The primary outcome was nodule specific distress and secondary outcomes included perceived lung cancer risk (with misperception defined as 15% discrepency), quality of communication with clinicians, and psychosocial factors that affect distress. Approximately half of the patients had distress, 24% of which was considered clinically significant. Only 25% of patients accurately estimated their risk of lung cancer, with the majority overestimating the likelihood of cancer. Many (41%) believed that if untreated their nodule would turn into cancer, and a majority (71%) did not know that pulmonary nodules can be benign or indolent tumors. While most physicians discussed nodule size with patients, only a small fraction reviewed the CT scan with the patient and discussed lung cancer risk. Greater than one third of patients stopped smoking when they found out they had a pulmonary nodule.