Let’s start with the harsh reality that lung cancer is already the malignant tumor with the highest incidence and mortality rate in China, with 700,000 to 800,000 new cases in 2014. One out of five patients who die from malignant tumors is lung cancer. The incidence of lung cancer in women is second only to breast cancer. Early stage lung cancer is often asymptomatic, and 70% to 80% of patients are already in advanced stage when they are found, losing the chance of surgery, but don’t be overly afraid! Early detection is the only way to early treatment, how to detect the first signs of lung cancer? Physical examination! Physical examination! Physical examination! Who should have a film? What kind of film should be taken? Is a small nodule in the lung necessarily cancer? Which small nodules should be alerted? To eliminate the honeyed fear of small nodules, let me tell you. First of all, let’s understand what is a small nodule in the lung? Imaging (such as chest X-ray, CT, etc.) found in the lung round lesions less than 3cm in diameter is generally known as “nodules”, if less than 1cm called “small nodules”, and less than 0.5cm in diameter is called “tiny or Small nodules”. The size alone does not determine good or bad. How should I take a film for a routine checkup? For economic cost and radiation reduction considerations, the general population under 40 years old can have an annual chest X-ray and, if necessary, a low-dose CT (LDCT) of the chest. The so-called high-risk group refers to: 1. people who have smoked for more than 20 years, smoke more than 20 cigarettes a day, or started smoking before the age of 20; 2. people with a family history of malignant tumors; 3. People who have a family history of malignant tumors, 3. People who work in a polluted environment for a long time. What is the advantage of CT over chest X-ray? The disadvantage of CT is that it is relatively expensive and the radiation is relatively large, but for the high-risk group, don’t be afraid of it, the radiation once a year will not cause significant health effects. The advantages of CT outweigh the disadvantages. Where can I get LDCT? The radiation of LDCT is about 1/5 of normal CT, which is equivalent to 15 x-ray chest exams or the natural radiation received by the human body for 6 months. In general, hospitals only have ordinary CT. To do LDCT, you need to go to a professional medical examination institution, a medical examination center of a general hospital or an oncology hospital, etc. You can consult first before going for the examination. Why are there more small lung nodules now than before? On the one hand, after the material level is improved, modern people are more “life conscious”, coupled with the active propaganda of clinicians, the public’s awareness of medical checkups has increased, and more and more people insist on annual medical checkups. On the one hand, the imaging equipment and examination technology are becoming more and more advanced, and the resolution and thin layer imaging ability of CT is greatly improved, so the small nodules that were difficult to be found by chest X-ray can no longer be hidden. On the other hand, air pollution (car exhaust, industrial waste gas, etc.), tobacco smoke (including second-hand smoke), indoor air pollution (decoration pollution, kitchen fumes), and frequent anger (the world is so beautiful, but you are so cranky, which is not good, not good), the “four gases” are always threatening people’s health. What should I do if I find a small nodule? If the nodule is less than 8mm and the edge is clear and smooth, it is likely to be benign. Any nodule larger than 8mm should be followed up regularly, usually every 3 months at the very beginning. The possibility of malignancy should be considered if the nodules do not have smooth edges and have red hair-like burrs. For some of the nodules that are difficult to determine, the doctor will give them 1-2 weeks of anti-inflammatory treatment before reviewing them, depending on the situation, and if the nodules shrink significantly or disappear, then there is nothing to worry about. If the nodules unfortunately do not change or tend to increase in size at follow-up, then it is recommended to see a thoracic surgeon as soon as possible. How to treat the small nodules suspected of lung cancer? There is no need to be overly alarmed. Early detection and early treatment generally have a better prognosis. Surgery is currently the best way to cure lung cancer. With the assistance of thoracoscopy, thoracic surgeons can complete the removal of nodules or even lobes of lung with a small minimally invasive incision of less than 5cm, which is less traumatic and quicker to recover, and there is usually no need for chemotherapy and radiotherapy after surgery. With early detection, the 5-year survival rate can reach more than 80%.