肺癌筛查（LCS）相关成像异常所造成的危害并未有充分记录，特别是在临床试验和学术设置以外。社区LCS计划涉及的侵入性程序和并发症频率是多少，包括对假阳性和良性但具有临床重要性的偶然发现进行的程序？我们进行了一项单中心、回顾性研究，研究2016年至2019年期间一所非大学教学医院的LCS计划，以确定LCS引起的侵入性程序，包括其指征和并发症。在2003名LCS参与者中，有58人（2.9%）被诊断为肺癌，71人（3.5%）被诊断为任何恶性肿瘤。共有160次侵入性程序在103人（5.1%）参与者中进行，其中包括无恶性肿瘤者的1.7%。对假阳性肺结节进行了8次侵入性程序（参与者的0.4%），包括四例手术（诊断性肺切除的12%）。在反转录-聚合酶链反应检测结果阴性的肺影像报告和数据系统4A级别的结节中，只有1%经历了侵入性程序。在那些没有恶性肿瘤的人中，8名参与者（0.4%）因发现胸腔外假阳性所接受了侵入性程序，19名参与者（0.9%）接受了评估良性但临床重要的偶然发现的侵入性程序。对于这些情况，程序在79%的人身上导致了治疗、管理变化或诊断。在没有恶性肿瘤的人中，侵入性程序导致了三种并发症（0.15%）。在那些有恶性肿瘤的人中，进行了70个非手术程序（6%的并发症率）和48个胸部手术（4%的重大并发症率）。在遵循结节管理算法并采用多学科方法的非大学LCS计划的临床实践中，使用侵入性程序解决假阳性结果并不常见。良性但临床重要的偶然发现的侵入性程序率与假阳性结果相似，并且往往具有临床价值。版权所有©2023 Elsevier Inc。

The harm associated with imaging abnormalities related to lung cancer screening (LCS) is not well-documented, especially outside the clinical trial and academic setting.What is the frequency of invasive procedures and complications associated with a community-based LCS program, including procedures for false-positive and benign but clinically important incidental findings?We performed a single center, retrospective study of a LCS program at a non-university teaching hospital from 2016 to 2019 to identify invasive procedures prompted by LCS, including their indication and complications.Among 2003 LCS participants, 58 (2.9%) were diagnosed with lung cancer and 71 (3.5%) with any malignancy. Invasive procedures were performed 160 times in 103 (5.1%) participants, including 1.7% of those without malignancy. Eight invasive procedures (0.4% of participants), including four surgeries (12% of diagnostic lung resections), were performed for false-positive lung nodules. Only 1% of Lung Imaging Reporting and Data System category 4A nodules that proved benign underwent an invasive procedure. Among those without malignancy, an invasive procedure was performed in eight participants for extrapulmonary false-positive findings (0.4%) and in 19 (0.9%) to evaluate incidental findings considered benign but clinically important. Procedures for the latter indication resulted in treatment, change in management, or diagnosis in 79% of individuals. Invasive procedures in those without malignancy resulted in three complications (0.15%). Seventy non-surgical procedures (6% complication rate) and 48 thoracic surgeries (4% major complication rate) were performed in those with malignancy.The use of invasive procedures to resolve false-positive findings was uncommon in the clinical practice of a non-university LCS program that adhered to a nodule management algorithm and employed a multidisciplinary approach. Incidental findings considered benign but clinically important resulted in invasive procedure rates that were similar to those for false-positive findings and frequently had clinical value.Copyright © 2023. Published by Elsevier Inc.