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NCCN Guidelines for Patients



Lung Cancer Screening, Version 1.2017


What happens after the first test? Follow-up or yearly screening LDCT

Follow-up or yearly screening LDCT

After the first follow-up test, you will have other

follow-up tests such as LDCT, chest CT, or PET/CT

as suggested by your doctor. Which test you receive

depends on the results of your first follow-up test.

Your doctor will compare your first follow-up test to

the first (baseline) screening test. Then, he or she

will decide when the next follow-up test will occur.

When the tests are done

Follow-up screening is done to check your lungs at

certain time points like months or years. The time

for follow-up LDCT tests are listed in the guides in

this chapter. You will learn about follow-up tests for

a solid, part-solid, and non-solid lung nodule. Your

doctors will let you know how often you will need

a screening test. Screening isn’t recommended

for people with poor health, who if diagnosed with

cancer would not be able to get curative treatment.

What your doctor is checking

Doctors will look for new nodules on a follow-up

LDCT. The doctor can check for any growth or

change in the density of nodules that were seen on

your first LDCT. In some cases, if there is a small

change, an LDCT will be recommended in 3 or 6

months. This allows your doctor to assess the nodule

sooner than waiting a year for your next screening

LDCT. The nodule may be caused by an infection,

inflammation, or cancer. If the nodule growth or size

of a new solid area is concerning for cancer, a biopsy

or surgery may be recommended.

Why more tests are needed

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 body.

If the PET/CT suggests that cancer isn’t likely, an

LDCT in 3 months is recommended. An LDCT is

done because some cancers may not be seen on

a PET scan. A chest CT can also be done in place

of a PET/CT to check a lung nodule. If the chest CT

or PET/CT suggests that cancer is likely, a biopsy

or surgery is recommended. To learn more about

biopsies and surgery, see Part 5.

Navigating the guides

The next set of guides (7–12) will list your

next screening test based on the type of

lung nodule found on a follow-up or yearly

screening test.