Overview of domain 1
Domain 1 is the starting point for users working through the IPN management framework. It helps you assess the existing governance conditions in your health system and set the programme up for success from the outset.
Why governance and guidelines matter
IPN management programmes do not operate in isolation. Their success depends on a clear understanding of the political context and policy environment the programme sits within, defined responsibilities, having the right people around the table from the start, and the selection of appropriate guidelines to inform the design of the programme. Ensuring governance and guidelines are addressed right at the outset of implementation makes every subsequent step more straightforward.
What this domain covers
Domain 1 guides users to:
Governing policy
- Understand the national and local policies on cancer, early detection and lung cancer, including specific control strategies relevant to IPN management are in place in the health system
- Gather existing data on lung cancer’s impact on the health system
Stakeholder consultation
- Assess who is involved in early detection, or IPN management activities, already in the health system
- Identify which stakeholder groups could be engaged to enable programme implementation
Guideline identification
- Choose suitable existing clinical guidelines for IPN management for the local context
Programme type
- Select the programme type, and size, that will be most suitable in the health system
Data governance
- Identify what medical imaging and health data storage systems are in place in the health system and how these can be leveraged for an IPN management programme
- Consider data privacy, access and consent policies that may facilitate, or hinder, implementation of an IPN management programme
Resources
Using data from your health system to demonstrate the need for an IPN management programme
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Identification of suitable guidelines for an IPN management programme
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Data governance to facilitate effective IPN management
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Pathways for IPN management programmes
DownloadFurther reading
- BTS guidelines for the investigation and management of pulmonary nodules (British Thoracic Society, 2015)
- BTS quality standards for the investigation and management of pulmonary nodules (British Thoracic Society, 2018)
- Guidelines for management of incidental pulmonary nodules detected on CT images: from the Fleischner Society (MacMahon et al.,2017)
- Incidentally detected indeterminate pulmonary nodule (American College of Radiology)
- Evaluation of individuals with pulmonary nodules: when is it lung cancer? Diagnosis and management of lung cancer, 3rd edn: evidence-based clinical practice guidelines (Gould et al., 2013)
- Evaluation of pulmonary nodules: clinical practice consensus guidelines for Asia (Bai et al., 2016)
- The Thoracic Society of Australia & New Zealand (TSANZ) practical guide for clinicians in the management of screen- and incidentally-detected nodules (Brims et al., 2025)
- Incidental pulmonary nodules – current guidelines and management [Inzidentelle Lungenrundherde – aktuelle Leitlinien und Management] (Glandorf & Vogel-Claussen, 2024)
- Incidental pulmonary nodules: what should we do in 2026? (Schmid-Bindert et al., 2026)
- Best practice guide for building lung cancer early detection programs (American Cancer Society & National Lung Cancer Roundtable)
- LungPlan (American Cancer Society & National Lung Cancer Roundtable)
- IPN measures and exam results (American College of Radiology, 2025)
- Promoting and prioritizing an integrated lung health approach (World Health Organization, 2025)
- ACR Appropriateness Criteria® incidentally detected indeterminate pulmonary nodule (Expert Panel on Thoracic Imaging, 2023)
- Managing incidental findings on thoracic CT: lung findings: a white paper of the ACR Incidental Findings Committee (Munden et al., 2021)