Clinical Outcomes of Ground-Glass Nodules Detected in a CT Lung Cancer Screening Program

Purpose To evaluate cancer outcomes, stage distribution, and mortality among patients with ground-glass nodules (GGNs) detected in a lung cancer screening program. Materials and Methods This retrospective study included patients in a CT lung cancer screening program (January 2015-July 2023) with a dominant GGN and a comparison group of patients with Lung Imaging Reporting and Data System (Lung-RADS) 1. All lung cancers in the GGN group were reviewed to determine whether they originated from the dominant nodule. Cancer stage and cause of death were obtained from medical records. Categorical variables were compared using the χ² test, and cancer development over time was compared using the log-rank test. Results Among 1724 patients (mean age, 65 years ± 6 [SD]; 917 female) in the screening program with a dominant GGN, 114 were diagnosed with lung cancer: 70 (61%) from the dominant GGN and 44 (39%) from another nodule. Stage 0 or I cancers were identified in 66 of 70 (94%) cancers arising from the dominant GGN versus 24 of 44 (55%) cancers from another nodule (P < .001). All 10 lung cancer-related deaths occurred from solid nodules unrelated to the GGNs. Patients with a dominant GGN were more likely than those with Lung-RADS 1 to develop cancers not related to the dominant nodule (P = .007). Conclusion Annual CT follow-up of patients with GGNs appears appropriate, as nearly all cancers were diagnosed at an early stage. However, these patients remain at risk for developing additional, separate lung cancers that may lead to mortality. Keywords: CT, Lung, Ground-Glass Nodules © RSNA, 2026.