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Practice Guideline
. 2012 Feb;10(2):240-65.
doi: 10.6004/jnccn.2012.0022.

Lung cancer screening

Douglas E Wood  1 , George A Eapen, David S Ettinger, Lifang Hou, David Jackman, Ella Kazerooni, Donald Klippenstein, Rudy P Lackner, Lorriana Leard, Ann N C Leung, Pierre P Massion, Bryan F Meyers, Reginald F Munden, Gregory A Otterson, Kimberly Peairs, Sudhakar Pipavath, Christie Pratt-Pozo, Chakravarthy Reddy, Mary E Reid, Arnold J Rotter, Matthew B Schabath, Lecia V Sequist, Betty C Tong, William D Travis, Michael Unger, Stephen C Yang
Affiliations
Practice Guideline

Lung cancer screening

Douglas E Wood et al. J Natl Compr Canc Netw. 2012 Feb.
No abstract available

PubMed Disclaimer

Conflict of interest statement

The NCCN guidelines staff have no conflicts to disclose.

Figures

None
aSmokers should always be encouraged to quit smoking (http://www.smokefree.gov/). bDocumented high radon exposure. cAgents that are identified specifically as carcinogens targeting the lungs: silica, cadmium, asbestos, arsenic, beryllium, chromium, diesel fumes, and nickel. dThere is increased risk of developing new primary lung cancer among survivors of lung cancer, lymphomas, cancers of the head and neck, or smoking-related cancers. eIndividuals exposed to secondhand smoke have a highly variable exposure to the carcinogens, with varying evidence for increased risk after this variable exposure. Therefore, secondhand smoke is not independently considered a risk factor for lung cancer screening. fAll screening and follow-up CT scans should be performed at low dose (100–120 kVp and 40–60 mAs or less), unless evaluating mediastinal abnormalities or lymph nodes, for which standard-dose CT with IV contrast might be appropriate. gWithout benign pattern of calcification, fat in nodule as in hamartoma, or features suggesting inflammatory etiology. When multiple nodules are present and occult infection or inflammation is a possibility, an added option is a course of a broad-spectrum antibiotic with anaerobic coverage, followed by low-dose CT 1–2 mo later. hIf new nodule at annual or follow-up LDCT, see page 245. New nodule is defined as ≥ 3 mm in mean diameter iThere is uncertainty about the appropriate duration of screening and the age at which screening is no longer appropriate. jMean diameter is the mean of the longest diameter of the nodule and its perpendicular diameter when compared with the baseline scan. kFor nodules ≤ 15 mm: increase in mean diameter ≥ 2 mm in any nodule or in the solid portion of a part solid nodule compared with baseline scan. For nodules ≥ 15 mm: increase in mean diameter of ≥ 15% compared with baseline scan. lRapid increase in size should raise suspicion of inflammatory etiology or malignancy other than NSCLC. mNew nodule is defined as ≥ 3 mm in mean diameter. nPET-CT for lesions ≥ 8 mm. *To view the most recent version of these guidelines, visit the NCCN Web site at www.NCCN.org.
None
aSmokers should always be encouraged to quit smoking (http://www.smokefree.gov/). bDocumented high radon exposure. cAgents that are identified specifically as carcinogens targeting the lungs: silica, cadmium, asbestos, arsenic, beryllium, chromium, diesel fumes, and nickel. dThere is increased risk of developing new primary lung cancer among survivors of lung cancer, lymphomas, cancers of the head and neck, or smoking-related cancers. eIndividuals exposed to secondhand smoke have a highly variable exposure to the carcinogens, with varying evidence for increased risk after this variable exposure. Therefore, secondhand smoke is not independently considered a risk factor for lung cancer screening. fAll screening and follow-up CT scans should be performed at low dose (100–120 kVp and 40–60 mAs or less), unless evaluating mediastinal abnormalities or lymph nodes, for which standard-dose CT with IV contrast might be appropriate. gWithout benign pattern of calcification, fat in nodule as in hamartoma, or features suggesting inflammatory etiology. When multiple nodules are present and occult infection or inflammation is a possibility, an added option is a course of a broad-spectrum antibiotic with anaerobic coverage, followed by low-dose CT 1–2 mo later. hIf new nodule at annual or follow-up LDCT, see page 245. New nodule is defined as ≥ 3 mm in mean diameter iThere is uncertainty about the appropriate duration of screening and the age at which screening is no longer appropriate. jMean diameter is the mean of the longest diameter of the nodule and its perpendicular diameter when compared with the baseline scan. kFor nodules ≤ 15 mm: increase in mean diameter ≥ 2 mm in any nodule or in the solid portion of a part solid nodule compared with baseline scan. For nodules ≥ 15 mm: increase in mean diameter of ≥ 15% compared with baseline scan. lRapid increase in size should raise suspicion of inflammatory etiology or malignancy other than NSCLC. mNew nodule is defined as ≥ 3 mm in mean diameter. nPET-CT for lesions ≥ 8 mm. *To view the most recent version of these guidelines, visit the NCCN Web site at www.NCCN.org.
None
aSmokers should always be encouraged to quit smoking (http://www.smokefree.gov/). bDocumented high radon exposure. cAgents that are identified specifically as carcinogens targeting the lungs: silica, cadmium, asbestos, arsenic, beryllium, chromium, diesel fumes, and nickel. dThere is increased risk of developing new primary lung cancer among survivors of lung cancer, lymphomas, cancers of the head and neck, or smoking-related cancers. eIndividuals exposed to secondhand smoke have a highly variable exposure to the carcinogens, with varying evidence for increased risk after this variable exposure. Therefore, secondhand smoke is not independently considered a risk factor for lung cancer screening. fAll screening and follow-up CT scans should be performed at low dose (100–120 kVp and 40–60 mAs or less), unless evaluating mediastinal abnormalities or lymph nodes, for which standard-dose CT with IV contrast might be appropriate. gWithout benign pattern of calcification, fat in nodule as in hamartoma, or features suggesting inflammatory etiology. When multiple nodules are present and occult infection or inflammation is a possibility, an added option is a course of a broad-spectrum antibiotic with anaerobic coverage, followed by low-dose CT 1–2 mo later. hIf new nodule at annual or follow-up LDCT, see page 245. New nodule is defined as ≥ 3 mm in mean diameter iThere is uncertainty about the appropriate duration of screening and the age at which screening is no longer appropriate. jMean diameter is the mean of the longest diameter of the nodule and its perpendicular diameter when compared with the baseline scan. kFor nodules ≤ 15 mm: increase in mean diameter ≥ 2 mm in any nodule or in the solid portion of a part solid nodule compared with baseline scan. For nodules ≥ 15 mm: increase in mean diameter of ≥ 15% compared with baseline scan. lRapid increase in size should raise suspicion of inflammatory etiology or malignancy other than NSCLC. mNew nodule is defined as ≥ 3 mm in mean diameter. nPET-CT for lesions ≥ 8 mm. *To view the most recent version of these guidelines, visit the NCCN Web site at www.NCCN.org.
None
aSmokers should always be encouraged to quit smoking (http://www.smokefree.gov/). bDocumented high radon exposure. cAgents that are identified specifically as carcinogens targeting the lungs: silica, cadmium, asbestos, arsenic, beryllium, chromium, diesel fumes, and nickel. dThere is increased risk of developing new primary lung cancer among survivors of lung cancer, lymphomas, cancers of the head and neck, or smoking-related cancers. eIndividuals exposed to secondhand smoke have a highly variable exposure to the carcinogens, with varying evidence for increased risk after this variable exposure. Therefore, secondhand smoke is not independently considered a risk factor for lung cancer screening. fAll screening and follow-up CT scans should be performed at low dose (100–120 kVp and 40–60 mAs or less), unless evaluating mediastinal abnormalities or lymph nodes, for which standard-dose CT with IV contrast might be appropriate. gWithout benign pattern of calcification, fat in nodule as in hamartoma, or features suggesting inflammatory etiology. When multiple nodules are present and occult infection or inflammation is a possibility, an added option is a course of a broad-spectrum antibiotic with anaerobic coverage, followed by low-dose CT 1–2 mo later. hIf new nodule at annual or follow-up LDCT, see page 245. New nodule is defined as ≥ 3 mm in mean diameter iThere is uncertainty about the appropriate duration of screening and the age at which screening is no longer appropriate. jMean diameter is the mean of the longest diameter of the nodule and its perpendicular diameter when compared with the baseline scan. kFor nodules ≤ 15 mm: increase in mean diameter ≥ 2 mm in any nodule or in the solid portion of a part solid nodule compared with baseline scan. For nodules ≥ 15 mm: increase in mean diameter of ≥ 15% compared with baseline scan. lRapid increase in size should raise suspicion of inflammatory etiology or malignancy other than NSCLC. mNew nodule is defined as ≥ 3 mm in mean diameter. nPET-CT for lesions ≥ 8 mm. *To view the most recent version of these guidelines, visit the NCCN Web site at www.NCCN.org.
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