NCCN Guidelines for Patients® | Lung Cancer Screening - page 21

NCCN Guidelines for Patients
: Lung Cancer Screening
Version 1.2014
Part 7: Dictionary
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4 The screening process
The chart above shows the recommended care based on
comparing the second screening test to the baseline test.
If the non-solid nodule has disappeared or gotten smaller,
there is a good chance that it was just a small infection
that resolved and not cancer. If a nodule has grown
or become more solid, it may be cancer and surgery
probably should be considered. A nodule about the same
size and density at follow-up suggests that it may be
cancer, but it also may be t benign. Since some of these
lung cancers grow very slowly, more follow-up testing
may be recommended.
For a 10 mm or smaller nodule that didn’t increase, yearly
screening is suggested. Screening should occur every year
for at least 2 years. After 2 years, your doctors may want you
to continue yearly screening. Screening isn’t recommended
for people with poor health, who if diagnosed with cancer
would not be able to receive curative treatment.
There are three options if there were no increases in
a nodule that was 10 mm or larger at baseline. Three
options are given because a nodule of this size is more
likely to be cancer than smaller nodules. First, another
follow-up LDCT could be done. If cancer is present,
Consider surgery
Biopsy, or
Baseline LDCT
Lung nodule ≤5 mm
Start yearly LDCT screening
Get another follow-up LDCT in 6–12 months,
No increase
No increase
Get another follow-up LDCT in 3–6 months, or
Consider surgery
Second LDCT
Recommended care
Lung nodule 5.1–10 mm
Start yearly LDCT screening
No increase
Lung nodule >10 mm
Care after second test
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