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 - © 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 - Humans
KW - Lung Neoplasms/diagnostic imaging
KW - Solitary Pulmonary Nodule/diagnostic imaging
KW - Multiple Pulmonary Nodules/diagnostic imaging
KW - Tomography, X-Ray Computed/methods
UR - http://www.scopus.com/inward/record.url?scp=85183924165&partnerID=8YFLogxK
U2 - 10.1159/000535595
DO - 10.1159/000535595
M3 - Review
C2 - 38253045
SN - 0025-7931
VL - 103
SP - 53
EP - 59
JO - Respiration; international review of thoracic diseases
JF - Respiration; international review of thoracic diseases
IS - 2
ER -