Every day, imaging carried out for unrelated reasons finds lung nodules that might indicate cancer. Most are benign, but a small proportion are not and may indicate lung cancer. And without embedded processes to identify, track and manage people with these nodules, there is a risk that lung cancer diagnoses slip through the system and are missed.
For many people with lung cancer, incidental detection offers a realistic route to detecting lung cancer earlier. They might fall outside screening eligibility, or live somewhere where a screening programme does not exist. Management of incidental pulmonary nodule (IPN) is a complementary cornerstone of any early detection strategy for lung cancer, but many health systems are not utilising it to its full potential.
What structured IPN management can deliver
Consistent, well-designed IPN management pathways help health systems:
- detect lung cancer earlier in people outside screening eligibility
- reduce the risk of findings being missed, lost to follow-up or inadequately acted upon
- provide a viable earlier detection route in settings where LDCT screening is not yet feasible
- complement established screening programmes by widening the net for earlier detection.
Our report
Our policy recommendations and implementation tools set out how health systems can build and strengthen IPN management pathways. They address:
- how to establish clear pathways covering detection, tracking and follow-up
- developing consistent guidelines to support clinical decision-making
- improving reporting and communication systems so findings are acted upon promptly
- strengthening multidisciplinary coordination for timely and appropriate care
- addressing system-level barriers, including workforce, infrastructure and technical capacity constraints.
The resources are designed for healthcare providers, health system leaders and policymakers looking to formalise IPN management or improve existing approaches, whether or not low-dose computed tomography (LDCT) screening is in place.