When doctors review diagnostic scans for lung cancer, they may find abnormalities that are not related to the lungs. New research shows that some of these abnormalities may be signs of other undiagnosed cancers.
The study, led by researchers at Brown University School of Public Health, analyzed lung screening data from more than 26,000 people who participated in the landmark National Lung Screening Trial. This large federal study helped establish computed tomography (CT) scans as the standard method for screening people at high risk for lung cancer, especially long-time smokers.
Because CT scans look at areas of the body other than the lungs, doctors often find abnormalities in other parts of the body, such as the kidneys, liver, or lymph nodes, that may indicate cancer. In the new study, researchers focused on specific types of these abnormalities and found that people with these findings were more likely to be diagnosed with cancer outside the lungs (extrapulmonary) within a year of screening.
In a study published in 2016, the authors JAMA network open, Addresses modern medicine’s challenge of balancing early detection with the risks of unnecessary tests and procedures. The results provide both patients and doctors with clearer guidance about what it means if a scan reveals something unexpected and which types of abnormalities are likely to be signs of extrapulmonary cancer.
Ultimately, the researchers said, the findings could help clinicians determine when follow-up care may detect cancer early and when it is not necessary.
This paper provides an evidence base for determining non-pulmonary abnormalities that may be seen during lung screening. The goal is to provide doctors and patients with better data so they can make more informed choices about which abnormalities should be considered for follow-up and which are more likely to be ignored. ”
Study author Ilana F. Galeen is a professor of epidemiology at Brown University.
As more people across the United States are tested for lung cancer, doctors will have an increased chance of detecting this type of abnormality, the researchers said. In a previous study, Gareen and colleagues found that about one in three participants in a national trial had potentially clinically important findings unrelated to lung cancer in their scan results. In the new study, researchers zeroed in on a subset of those findings – abnormalities that doctors have identified as possible signs of cancer – to better understand what may require follow-up or treatment.
The results showed that among more than 75,000 scans performed across three CT screenings, cancer-related findings appeared in about 3% of screening rounds and 6.8% of participants. Participants with these abnormalities had a significantly higher risk of being diagnosed with non-lung cancer within a year. The strongest associations were seen with urinary system cancers, such as kidney and bladder cancers, and other cancers, such as lymphoma and leukemia.
Gareen said she next wanted to consider whether the results are consistent with the experience of patients currently being screened in the community to determine whether the abnormalities and associated cancer rates seen in the National Lung Screening Trial can be replicated outside of clinical trials.
Other Brown researchers involved in the study included Lowy Gutman, Marianne Thangaraja, and Amal N. Trivedi. The study also included researchers from Providence VA Medical Center, Duke Health, Massachusetts General Hospital, Atrium Health Wake Forest Baptist, and the University of Iowa. Funded by the National Cancer Institute (R01CA204222).
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Reference magazines:
Galeen, If province; others. (2026). Significant incidental findings in the national lung screening examination and diagnosis of extrapulmonary cancer. JAMA network open. DOI: 10.1001/jamanetworkopen.2026.3398. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2847140
