TY - JOUR

T1 - Consequences of Losing Incidental Pulmonary Nodules to Follow-Up

T2 - Unmonitored Nodules Progressing to Stage IV Lung Cancer

AU - Borg, Morten

AU - Kristensen, Katrine

AU - Alstrup, Gitte

AU - Mamaeva, Tatiana

AU - Arshad, Arman

AU - Laursen, Christian B.

AU - Hilberg, Ole

AU - Bodtger, Uffe

AU - Andersen, Michael Brun

AU - Rasmussen, Torben Riis

N1 - Publisher Copyright: © 2024 S. Karger AG, Basel.

PY - 2024

Y1 - 2024

N2 - Introduction: Lung cancer is the leading cause of cancer-related death globally. Incidental pulmonary nodules represent a golden opportunity for early diagnosis, which is critical for improving survival rates. This study explores the impact of missed pulmonary nodules on the progression of lung cancer. Methods: A total of 4,066 stage IV lung cancer cases from 2019 to 2021 in Danish hospitals were investigated to determine whether a chest computed tomography (CT) had been performed within 2 years before diagnosis. CT reports and images were reviewed to identify nodules that had been missed by radiologists or were not appropriately monitored, despite being mentioned by the radiologist, and to assess whether these nodules had progressed to stage IV lung cancer. Results: Among stage IV lung cancer patients, 13.6% had undergone a chest CT scan before their diagnosis; of these, 44.4% had nodules mentioned. Radiologists missed a nodule in 7.6% of cases. In total, 45.3% of nodules were not appropriately monitored. An estimated 2.5% of stage IV cases could have been detected earlier with proper surveillance. Conclusion: This study underlines the significance of monitoring pulmonary nodules and proposes strategies for enhancing detection and surveillance. These strategies include centralized monitoring and the implementation of automated registries to prevent gaps in follow-up.

AB - Introduction: Lung cancer is the leading cause of cancer-related death globally. Incidental pulmonary nodules represent a golden opportunity for early diagnosis, which is critical for improving survival rates. This study explores the impact of missed pulmonary nodules on the progression of lung cancer. Methods: A total of 4,066 stage IV lung cancer cases from 2019 to 2021 in Danish hospitals were investigated to determine whether a chest computed tomography (CT) had been performed within 2 years before diagnosis. CT reports and images were reviewed to identify nodules that had been missed by radiologists or were not appropriately monitored, despite being mentioned by the radiologist, and to assess whether these nodules had progressed to stage IV lung cancer. Results: Among stage IV lung cancer patients, 13.6% had undergone a chest CT scan before their diagnosis; of these, 44.4% had nodules mentioned. Radiologists missed a nodule in 7.6% of cases. In total, 45.3% of nodules were not appropriately monitored. An estimated 2.5% of stage IV cases could have been detected earlier with proper surveillance. Conclusion: This study underlines the significance of monitoring pulmonary nodules and proposes strategies for enhancing detection and surveillance. These strategies include centralized monitoring and the implementation of automated registries to prevent gaps in follow-up.

KW - Computed tomography

KW - Early-stage lung cancer

KW - Incidental pulmonary nodules

KW - Lung cancer

KW - Stage IV lung cancer

KW - Survival

U2 - 10.1159/000535595

DO - 10.1159/000535595

M3 - Journal article

C2 - 38253045

AN - SCOPUS:85183924165

VL - 103

SP - 53

EP - 59

JO - Respiration

JF - Respiration

SN - 0025-7931

IS - 2

ER -