Background
Appropriate management of lung nodules detected incidentally or through lung cancer screening can increase the rate of early-stage diagnoses and potentially improve treatment outcomes. However, the implementation and management of comprehensive lung nodule programs is challenging.
Methods
A single-center, retrospective study was conducted to describe the development and outcomes of a lung nodule program at a community practice in Tennessee.
Results
The number of patients with lung nodules referred to the program increased over 2 years, with 665 patients in Year 1 and 745 patients in Year 2. Most nodules were incidental (60% Year 1, 65% Year 2). In Year 1, 17% of nodules were symptomatic and 12% were identified through screening. Of the 665 nodules in Year 1, 182 underwent a diagnostic intervention and 121 (18%) received a cancer diagnosis. Most diagnostic interventions were image-guided bronchoscopy (88%) or percutaneous biopsy (9%). The proportion of Stage I-II cancer diagnoses increased from 23% prior to program implementation to 36% in Year 1 and 38% in Year 2. Among screening cases, follow-up scans were conducted within 18 months in 71%. Only 2% of patients under watchful waiting required a diagnostic intervention, of which 1% received a cancer diagnosis.
Conclusions
The current study reports outcomes over the first two years of a lung cancer screening and incidental nodule program. The program was successful and manageable, given the appropriate level of data management and oversight. Comprehensive lung nodule programs have the potential to benefit the patient, physician, and hospital system.

Figure 1

Figure 2

Figure 3
Loading...
On 31 Mar, 2020
Received 03 Feb, 2020
On 27 Jan, 2020
On 24 Jan, 2020
Invitations sent on 24 Jan, 2020
On 23 Jan, 2020
On 23 Jan, 2020
Posted 09 Dec, 2019
Received 02 Jan, 2020
On 02 Jan, 2020
On 19 Dec, 2019
Received 19 Dec, 2019
Received 19 Dec, 2019
On 16 Dec, 2019
On 10 Dec, 2019
Invitations sent on 09 Dec, 2019
On 08 Dec, 2019
On 05 Dec, 2019
On 02 Dec, 2019
On 26 Nov, 2019
On 31 Mar, 2020
Received 03 Feb, 2020
On 27 Jan, 2020
On 24 Jan, 2020
Invitations sent on 24 Jan, 2020
On 23 Jan, 2020
On 23 Jan, 2020
Posted 09 Dec, 2019
Received 02 Jan, 2020
On 02 Jan, 2020
On 19 Dec, 2019
Received 19 Dec, 2019
Received 19 Dec, 2019
On 16 Dec, 2019
On 10 Dec, 2019
Invitations sent on 09 Dec, 2019
On 08 Dec, 2019
On 05 Dec, 2019
On 02 Dec, 2019
On 26 Nov, 2019
Background
Appropriate management of lung nodules detected incidentally or through lung cancer screening can increase the rate of early-stage diagnoses and potentially improve treatment outcomes. However, the implementation and management of comprehensive lung nodule programs is challenging.
Methods
A single-center, retrospective study was conducted to describe the development and outcomes of a lung nodule program at a community practice in Tennessee.
Results
The number of patients with lung nodules referred to the program increased over 2 years, with 665 patients in Year 1 and 745 patients in Year 2. Most nodules were incidental (60% Year 1, 65% Year 2). In Year 1, 17% of nodules were symptomatic and 12% were identified through screening. Of the 665 nodules in Year 1, 182 underwent a diagnostic intervention and 121 (18%) received a cancer diagnosis. Most diagnostic interventions were image-guided bronchoscopy (88%) or percutaneous biopsy (9%). The proportion of Stage I-II cancer diagnoses increased from 23% prior to program implementation to 36% in Year 1 and 38% in Year 2. Among screening cases, follow-up scans were conducted within 18 months in 71%. Only 2% of patients under watchful waiting required a diagnostic intervention, of which 1% received a cancer diagnosis.
Conclusions
The current study reports outcomes over the first two years of a lung cancer screening and incidental nodule program. The program was successful and manageable, given the appropriate level of data management and oversight. Comprehensive lung nodule programs have the potential to benefit the patient, physician, and hospital system.

Figure 1

Figure 2

Figure 3
Loading...