See the published version of this preprint at BMC Pulmonary Medicine.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
Research article
Gregory LeMense
Bozeman Deaconess Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2164-2988
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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: This single-center, retrospective report describes the development and outcomes of a comprehensive lung nodule program at a community practice in Tennessee. Computed tomography (CT) scans potentially revealing incidental lung nodules were identified by a computerized search. Incidental or screening-identified lung nodules that were enlarging or not seen in prior scans were entered into a nodule database and guideline-based review determined whether to conduct a diagnostic intervention or radiologic follow-up. Referral rates, diagnosis methods, stage distribution, treatment modalities, and days to treatment are reported.
Results: The number of patients with lung nodules referred to the program increased over 2 years, from 665 patients in Year 1 to 745 patients in Year 2. Most nodules were incidental (62%-65%). Nodules identified with symptoms (15.2% in Year 1) or through screening (12.6% in Year 1) were less common. In Year 1, 27% (182/665) of nodules required a diagnostic intervention and 18% (121/665) were malignant. 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. In screening cases, 71% of patients completed follow-up scans within 18 months. Only 2% of Year 1 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 results show that the program was successful, given the appropriate level of data management and oversight. Comprehensive lung nodule programs have the potential to benefit the patient, physician, and hospital system.
Keywords
Lung Nodule, Lung Cancer, Incidental Lung Nodule, Lung Cancer Screening, Interventional Pulmonology
Figure 1
Figure 2
Figure 3
Loading...
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Pulmonary Medicine.
Version 2
Posted 27 Jan, 2020
No community comments so far
Editorial decision: Accept
On 31 Mar, 2020
Review #1 received
Received 03 Feb, 2020
Reviewer #1 agreed
On 27 Jan, 2020
Editor assigned
On 24 Jan, 2020
Reviewers invited
Invitations sent on 24 Jan, 2020
Submission checks complete
On 23 Jan, 2020
Editor invited
On 23 Jan, 2020
No comments provided
Review #2 received
Received 02 Jan, 2020
Editorial decision: Major revision
On 02 Jan, 2020
Reviewer #3 agreed
On 19 Dec, 2019
Review #3 received
Received 19 Dec, 2019
Review #1 received
Received 19 Dec, 2019
Reviewer #2 agreed
On 16 Dec, 2019
Reviewer #1 agreed
On 10 Dec, 2019
Reviewers invited
Invitations sent on 09 Dec, 2019
Editor assigned
On 08 Dec, 2019
Submission checks complete
On 05 Dec, 2019
Editor invited
On 02 Dec, 2019
First submitted
On 26 Nov, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Pulmonology
Learn more about our company.
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Pulmonary Medicine.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Gregory LeMense
Bozeman Deaconess Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2164-2988
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Pulmonary Medicine.
Version 2
Posted 27 Jan, 2020
No community comments so far
Editorial decision: Accept
On 31 Mar, 2020
Review #1 received
Received 03 Feb, 2020
Reviewer #1 agreed
On 27 Jan, 2020
Editor assigned
On 24 Jan, 2020
Reviewers invited
Invitations sent on 24 Jan, 2020
Submission checks complete
On 23 Jan, 2020
Editor invited
On 23 Jan, 2020
No comments provided
Review #2 received
Received 02 Jan, 2020
Editorial decision: Major revision
On 02 Jan, 2020
Reviewer #3 agreed
On 19 Dec, 2019
Review #3 received
Received 19 Dec, 2019
Review #1 received
Received 19 Dec, 2019
Reviewer #2 agreed
On 16 Dec, 2019
Reviewer #1 agreed
On 10 Dec, 2019
Reviewers invited
Invitations sent on 09 Dec, 2019
Editor assigned
On 08 Dec, 2019
Submission checks complete
On 05 Dec, 2019
Editor invited
On 02 Dec, 2019
First submitted
On 26 Nov, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Pulmonology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Pulmonary Medicine.
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: This single-center, retrospective report describes the development and outcomes of a comprehensive lung nodule program at a community practice in Tennessee. Computed tomography (CT) scans potentially revealing incidental lung nodules were identified by a computerized search. Incidental or screening-identified lung nodules that were enlarging or not seen in prior scans were entered into a nodule database and guideline-based review determined whether to conduct a diagnostic intervention or radiologic follow-up. Referral rates, diagnosis methods, stage distribution, treatment modalities, and days to treatment are reported.
Results: The number of patients with lung nodules referred to the program increased over 2 years, from 665 patients in Year 1 to 745 patients in Year 2. Most nodules were incidental (62%-65%). Nodules identified with symptoms (15.2% in Year 1) or through screening (12.6% in Year 1) were less common. In Year 1, 27% (182/665) of nodules required a diagnostic intervention and 18% (121/665) were malignant. 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. In screening cases, 71% of patients completed follow-up scans within 18 months. Only 2% of Year 1 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 results show that the program was successful, 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...