Cancer or harmless? Doctors grapple with a rise in ‘incidentalomas’

They are the small, dark spots on medical scans that no one expected. They could be harmless, or life-threatening, and they are on the rise.

“When I started, a CT scan of a brain was 24 slices, and now it is 240. The abdomen and pelvis slices used to be five-millimetre slices; now we are down to one millimetre.”He said the vast majority of these incidental findings were harmless, with just 1 per cent serious enough to warrant treatment. These more serious findings include cancers, aneurysms and blood clots.

The study’s co-author, Professor Ian Scott, decided to look into the phenomenon after a 72-year-old patient recently presented with kidney stone pain at his Queensland hospital. An abdominal CT scan revealed a lesion in his pancreas, which doctors worried was cancer. Kym Walker is forever grateful for her incidental diagnosis. After tripping over some rocks while holidaying in Apollo Bay in 2021, the Geelong mother of three had a scan that revealed she had broken a bone in her back. But it also revealed something more concerning: some lesions on her liver.

“If this doesn’t work there is no other option for me,” she said. “I will be given a terminal diagnosis.” “If you have a history of cancer, a new nodule somewhere becomes far more interesting than in a 20-year-old with no such history.”

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