NCCN Guidelines for Patients® | Lung Cancer Screening - page 24

NCCN Guidelines for Patients
: Lung Cancer Screening
Version 1.2014
Part 4: The screening process
New nodules
Infection, inflammation, or cancer
Follow-up test
Nodule is gone
Yearly LDCT screening
Follow-up LDCT until nodule
is gone or stopped shrinking
Biopsy, or
Nodule is smaller
Nodule is the same
size or larger
nodule >8 mm
Likely not cancer
May be cancer
Recommended care
Follow-up LDCT in 1–2
months after treatment for
infection or inflammation
Follow-up result
During the screening process, a new nodule may appear.
The nodule may be caused by an infection, inflammation,
or cancer. If your doctors think the nodule is caused by
cancer, the recommended care for the types of nodules
described earlier should be followed. The suggested
course of care if your doctors think there’s an infection or
inflammation is described next.
The nodule should be re-assessed with LDCT in 1 to
2 months. During this time, your doctors may treat the
infection or inflammation. If the nodule is smaller or gone,
it is not likely to be cancer. Screening with yearly or
follow-up LDCT is suggested.
There may be cancer if the nodule is the same size or
larger. A PET/CT is suggested rather than LDCT if the
nodule is larger than 8 mm. PET/CT may find if there’s
cancer quicker than LDCTs repeated over a period of
time. It may also show signs of cancer spreading in the
If the PET/CT suggests that cancer isn’t likely, a follow-up
LDCT in 3 months is recommended. A follow-up LDCT
is done because some cancers may not be seen on a
PET scan. If the PET/CT suggests that cancer is likely,
a biopsy or surgery is recommended. See Part 5, which
starts on the next page, for more information.
Follow-up LDCT
in 3 months
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