央视网消息：每年的11月是"全球肺癌关注月"。肺癌是我国发病率、死亡率最高的恶性肿瘤。随着胸部CT的普及，越来越多的肺结节被筛查出来。眼下正 值年底体检高峰，一旦体检发现肺结节，就意味着会有发展成肺癌的风险吗？肺结节是否需要立刻手术呢？ 肺结节≠肺癌 绝大多数是良性 专家介绍，2毫米以上的结节都能在CT上发现。肺结节不等于肺癌，而且绝大多数是良性的，胸部CT检查初次发现肺结节，先不要恐慌，应根据医生的建 议定期复查，观察肺结节的变化。 北京大学人民医院副院长 杨帆：大家在很多地方，把磨玻璃（结节）去制造了太多的焦虑，把磨玻璃（结节）太多地等同于肺癌，产生了大量的过度诊断 和过度治疗。 今年53岁的郭女士，刚刚在四川大学华西医院接受了肺结节微创手术，体表只有一个创可贴就可以贴住的3mm大小的伤口。郭女士在2021年体检时，发现 右肺有一个小结节，大小约为4毫米。今年复查显示，结节长到了6毫米，并且形态较为可疑。这个小结节成了郭女士的一块心病，不开刀担心是肺癌，开刀 要切除一大块肺组织，心里又很害怕。 患者 郭女士：医生说了我是高危结节，所以说一直在心里，都是一个定时炸弹，每年都担心。所以说每年我都在随诊复查，今 ...

Core Viewpoint - The increasing detection of pulmonary nodules through chest CT scans is linked to heightened health awareness and advancements in medical imaging technology, rather than a true increase in incidence rates [2][6][8]. Group 1: Detection Rates and Incidence - The probability of detecting pulmonary nodules during health check-ups is nearly 30% among the population, but this does not equate to a higher actual incidence of pulmonary nodules [2][3]. - The detection rate is influenced by factors such as the sensitivity of imaging technology, equipment resolution, and the experience of medical professionals, leading to significant regional and demographic variations [2][3][5]. Group 2: Technological Advancements - The rise in detection rates is primarily attributed to advancements in medical testing technology, including the widespread use of high-precision imaging devices like CT scans, which can identify smaller nodules that traditional X-rays might miss [6][7]. - The integration of artificial intelligence in imaging diagnostics has further enhanced the sensitivity of screenings, allowing for the detection of previously undetectable small nodules [6][7]. Group 3: Psychological Impact - The discovery of pulmonary nodules often leads to increased anxiety among patients, with a significant percentage experiencing psychological distress despite the majority of nodules being benign [8][10]. - Many patients misunderstand the nature of pulmonary nodules, leading to unnecessary fears about cancer, as 95% of detected nodules are benign [8][10]. Group 4: Health Awareness and Screening Practices - There has been a notable shift in public attitude towards lung health, particularly post-COVID-19, with more individuals opting for proactive health screenings [7][8]. - Some commercial health check-up providers promote cancer screening aggressively, which may contribute to increased detection rates but also raises concerns about unnecessary anxiety and overdiagnosis [7][8].

Core Viewpoint - The increasing detection of lung nodules during health check-ups is attributed to advancements in imaging technology, particularly the widespread use of low-dose spiral CT scans, rather than a sudden rise in their occurrence [1]. Group 1: Understanding Lung Nodules - Lung nodules are defined as small round spots in the lung tissue, typically less than 3 cm in diameter, with larger nodules classified as lung masses [3]. - Lung nodules can be categorized based on their internal density as pure ground-glass nodules, part-solid nodules, and solid nodules [3]. Group 2: Assessment Criteria for Lung Nodules - Nodules measuring ≤6 mm should be observed without immediate intervention [5]. - Nodules between 6-8 mm require close monitoring to rule out early lung cancer [6]. - Nodules ≥8 mm are considered a warning threshold, necessitating immediate medical attention if there is any increase in size, density, or irregular shape [6]. - Nodules ≥1 cm with high-risk factors may warrant surgical consideration [7]. Group 3: Characteristics of Nodules - Nodules with smooth edges and small size are likely benign, referred to as "high-quality" nodules [8]. - Nodules exhibiting features such as spiculation, pleural retraction, or vascular encasement are considered "low-quality" and may indicate malignancy [9]. Group 4: Ground-Glass Nodules - Not all ground-glass nodules are cancerous; they can also result from various conditions like inflammation or fibrosis [10]. - Early-stage lung cancer often presents as pure ground-glass nodules, with a high 5-year survival rate if treated [10]. - Nodules with solid components have an increased risk of malignancy but can still be treated effectively if addressed promptly [11]. Group 5: Risk Factors and Recommendations - The main risk factors for lung cancer include tobacco exposure, air pollution, occupational hazards, chronic obstructive pulmonary disease, and family history [13]. - High-risk individuals aged ≥50 should undergo annual low-dose spiral CT scans, especially if they have significant smoking history or exposure [13]. - Preventive measures include quitting smoking, minimizing exposure to secondhand smoke, and maintaining a healthy lifestyle [13][17].

Group 1 - The article highlights various carcinogenic substances that are often overlooked in daily life, emphasizing the importance of awareness and preventive measures for health [1] - Groundnut oil, particularly the unrefined type, is identified as a significant source of aflatoxin contamination, which poses serious health risks [2] - Betel nut is classified as a Group 1 carcinogen by the International Agency for Research on Cancer, with a strong association with oral cancer and high addiction potential [5] Group 2 - Oral cancer is the most common malignant tumor in the head and neck region, with approximately 300,000 new cases globally each year, and around 58,000 new cases in China annually, predominantly in males [7] - Cooking fumes are a major source of indoor air pollution, significantly increasing the risk of lung cancer, especially among non-smoking women who are regularly exposed [8] - Consumption of raw freshwater fish and shrimp poses a risk of infection from liver flukes, which are also classified as Group 1 carcinogens, highlighting the need for proper food handling and cooking practices [11]

Core Insights - Lung nodules have become common in health check reports, with most being benign, but regular follow-ups are essential based on nodule characteristics [1][2] Group 1: Lung Nodule Management - 95% of lung nodules are benign, with only 5% having the potential for malignancy [2] - Recommendations for follow-up include: - Ground-glass nodules under 5mm should be reviewed every six months - Nodules between 5mm and 1cm should be followed up every three months - Mixed nodules under 8mm should follow a 3-6-12 month follow-up schedule, while those over 8mm may require intervention [2] - Solid nodules require comprehensive evaluation based on size and edge characteristics, with anti-inflammatory treatment potentially ruling out malignancy if nodules shrink [2] Group 2: Lung Cancer Risk Factors - Lung cancer has the highest incidence and mortality rates among all malignancies in China, with primary risk factors including smoking, occupational exposure, and chronic lung diseases [3] - Smoking significantly increases cancer risk, with smokers having a 4-10 times higher mortality rate compared to non-smokers [3] - Passive smoking and occupational exposures, such as asbestos and air pollution, also contribute to increased risk [3] Group 3: Lung Cancer Treatment Approaches - The pathological classification of lung cancer determines treatment strategies, with small cell lung cancer (15% of cases) being highly malignant but treatable with combined therapies extending median survival from 18 months to 55.9 months [4] - Immunotherapy combined with chemotherapy has become a first-line treatment for extensive small cell lung cancer, achieving an objective response rate of 60%-70% [4] - Despite advancements in targeted and immunotherapy, chemotherapy remains a crucial treatment method, with modern regimens improving management of side effects [4]