Keywords:
Quality assurance, Cancer, Health policy and practice, Decision analysis, Audit and standards, CT, Thorax, Oncology, Lung
Authors:
H. R. ALOMAISH1, A. Suhail2, C. Crocker2, V. Luong2, D. Manos3; 1Toronto, ON/CA, 2Halifax/CA, 3Halifax, NS/CA
DOI:
10.26044/esti2019/P-0023
Conclusion
A minority (10%) of lung cancers are diagnosed through CT surveillance programs of low or intermediate risk pulmonary nodules. Nonetheless,
nodule follow up CTs are an important pathway to lung cancer diagnosis,
predominantly in patients with a smoking history.
Cancers detected through nodule surveillance programs are more likely to be adenocarcinomas and more likely to be at early stages of disease.
In our health care region,
radiologist failure to compare with remote images as well as false negative work up,
including false negative biopsy or PETCT,
prolong treatment delays. Research repeatedly shows that serial growth on CT is a strong cancer risk factor (7,17). When successive CTs demonstrate growth,
radiologists may wish to consider using definitive report terminology that indicates the necessity of additional investigation if work up is initially negative.