The Lung Cancer Policy Network has launched a toolkit to help health systems design, plan and implement programmes that manage incidental pulmonary nodules (IPNs), opening a route to earlier detection of lung cancer outside risk-based screening.
When a scan captures part of the lung, it can reveal small lesions known as incidental pulmonary nodules (IPNs). Most are benign, but around 1.5% are malignant. Managing these nodules well offers a way to detect lung cancer earlier, whether or not a formal screening programme exists.
New to IPNs? Our FAQ blog post answers the most common questions.
IPN management programmes have been shown to support earlier detection, including in people who are not eligible for screening. Yet in many health systems, nodules are still missed, lost to follow-up or never acted on. Recent data shows that only 36-57% of people receive appropriate follow-up care of their IPNs. The Network’s new implementation toolkit sets out to close that gap. It helps users assess whether their health system is ready for an IPN management programme, then guides them through designing, planning and delivering one.
The toolkit builds on the Network’s 2024 report, Enhancing the earlier detection of lung cancer: effective management of incidental pulmonary nodules. The report set out recommendations for policymakers on how to find, track and manage IPNs. Where the report made the case for change, the toolkit turns to how that change can happen in practice.
Who is the implementation toolkit for?
The toolkit is for anyone involved in planning, designing or delivering programmes within a health system, including clinicians, researchers, administrators and managers. It is designed to work in health systems with different levels of resourcing, including where lung cancer screening is not yet in place.
It was developed with Network members and other experts in IPN management.
Dr Joelle Fathi, Chief Healthcare Delivery Officer, GO2 for Lung Cancer, US
What does the implementation toolkit include?
At the heart of the toolkit is an implementation framework covering six domains of the health system, from governance and financial planning to service delivery and quality assurance. The framework’s key metrics help users assess their system’s readiness and shape a programme of their own. Alongside the framework, the implementation toolkit includes:
- five case studies of IPN management programmes from the Mississippi Delta, US; Nottingham, England; Vancouver, Canada; Recife, Brazil, and Chanthaburi, Thailand, setting out how each works, what makes it function and key takeaways for others
- three expert videos exploring domains of the framework and what to consider when designing a programme
- seven supporting documents with further guidance on understanding and applying the framework
- a visual overview of every part of the toolkit
- a video walkthrough showing how to find your way around the toolkit
- a database of external resources, each signposting to the relevant domains of the framework
- the framework methodology, including the protocol used to test the framework.
More to come during Lung Cancer Awareness Month
Throughout Lung Cancer Awareness Month in November, Network members will share their experience of IPN management in a series of blogs, from setting up a programme to making it work in low- and middle-income countries.
