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Growing small solid nodules in lung cancer screening: safety and efficacy of a 200 mm(3) minimum size threshold for multidisciplinary team referral
The optimal management of small but growing nodules remains unclear. The SUMMIT study nodule management algorithm uses a specific threshold volume of 200 mm(3) before referral of growing solid nodules to the multidisciplinary team for further investigation is advised, with growing nodules below this...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9872225/ https://www.ncbi.nlm.nih.gov/pubmed/36428100 http://dx.doi.org/10.1136/thorax-2022-219403 |
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author | Creamer, Andrew W Horst, Carolyn Dickson, Jennifer L Tisi, Sophie Hall, Helen Verghese, Priyam Prendecki, Ruth Bhamani, Amyn McCabe, John Gyertson, Kylie Mullin, Anne-Marie Teague, Jonathan Farrelly, Laura Hackshaw, Allan Nair, Arjun Devaraj, Anand Janes, Sam M |
author_facet | Creamer, Andrew W Horst, Carolyn Dickson, Jennifer L Tisi, Sophie Hall, Helen Verghese, Priyam Prendecki, Ruth Bhamani, Amyn McCabe, John Gyertson, Kylie Mullin, Anne-Marie Teague, Jonathan Farrelly, Laura Hackshaw, Allan Nair, Arjun Devaraj, Anand Janes, Sam M |
author_sort | Creamer, Andrew W |
collection | PubMed |
description | The optimal management of small but growing nodules remains unclear. The SUMMIT study nodule management algorithm uses a specific threshold volume of 200 mm(3) before referral of growing solid nodules to the multidisciplinary team for further investigation is advised, with growing nodules below this threshold kept under observation within the screening programme. Malignancy risk of growing solid nodules of size >200 mm(3) at initial 3-month interval scan was 58.3% at a per-nodule level, compared with 13.3% in growing nodules of size ≤200 mm(3) (relative risk 4.4, 95% CI 2.17 to 8.83). The positive predictive value of a combination of nodule growth (defined as percentage volume change of ≥25%), and size >200 mm(3) was 65.9% (29/44) at a cancer-per-nodule basis, or 60.5% (23/38) on a cancer-per-participant basis. False negative rate of the protocol was 1.9% (95% CI 0.33% to 9.94%). These findings support the use of a 200 mm(3) minimum volume threshold for referral as effective at reducing unnecessary multidisciplinary team referrals for small growing nodules, while maintaining early-stage lung cancer diagnosis. |
format | Online Article Text |
id | pubmed-9872225 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-98722252023-01-25 Growing small solid nodules in lung cancer screening: safety and efficacy of a 200 mm(3) minimum size threshold for multidisciplinary team referral Creamer, Andrew W Horst, Carolyn Dickson, Jennifer L Tisi, Sophie Hall, Helen Verghese, Priyam Prendecki, Ruth Bhamani, Amyn McCabe, John Gyertson, Kylie Mullin, Anne-Marie Teague, Jonathan Farrelly, Laura Hackshaw, Allan Nair, Arjun Devaraj, Anand Janes, Sam M Thorax Brief Communication The optimal management of small but growing nodules remains unclear. The SUMMIT study nodule management algorithm uses a specific threshold volume of 200 mm(3) before referral of growing solid nodules to the multidisciplinary team for further investigation is advised, with growing nodules below this threshold kept under observation within the screening programme. Malignancy risk of growing solid nodules of size >200 mm(3) at initial 3-month interval scan was 58.3% at a per-nodule level, compared with 13.3% in growing nodules of size ≤200 mm(3) (relative risk 4.4, 95% CI 2.17 to 8.83). The positive predictive value of a combination of nodule growth (defined as percentage volume change of ≥25%), and size >200 mm(3) was 65.9% (29/44) at a cancer-per-nodule basis, or 60.5% (23/38) on a cancer-per-participant basis. False negative rate of the protocol was 1.9% (95% CI 0.33% to 9.94%). These findings support the use of a 200 mm(3) minimum volume threshold for referral as effective at reducing unnecessary multidisciplinary team referrals for small growing nodules, while maintaining early-stage lung cancer diagnosis. BMJ Publishing Group 2023-02 2022-11-25 /pmc/articles/PMC9872225/ /pubmed/36428100 http://dx.doi.org/10.1136/thorax-2022-219403 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Brief Communication Creamer, Andrew W Horst, Carolyn Dickson, Jennifer L Tisi, Sophie Hall, Helen Verghese, Priyam Prendecki, Ruth Bhamani, Amyn McCabe, John Gyertson, Kylie Mullin, Anne-Marie Teague, Jonathan Farrelly, Laura Hackshaw, Allan Nair, Arjun Devaraj, Anand Janes, Sam M Growing small solid nodules in lung cancer screening: safety and efficacy of a 200 mm(3) minimum size threshold for multidisciplinary team referral |
title | Growing small solid nodules in lung cancer screening: safety and efficacy of a 200 mm(3) minimum size threshold for multidisciplinary team referral |
title_full | Growing small solid nodules in lung cancer screening: safety and efficacy of a 200 mm(3) minimum size threshold for multidisciplinary team referral |
title_fullStr | Growing small solid nodules in lung cancer screening: safety and efficacy of a 200 mm(3) minimum size threshold for multidisciplinary team referral |
title_full_unstemmed | Growing small solid nodules in lung cancer screening: safety and efficacy of a 200 mm(3) minimum size threshold for multidisciplinary team referral |
title_short | Growing small solid nodules in lung cancer screening: safety and efficacy of a 200 mm(3) minimum size threshold for multidisciplinary team referral |
title_sort | growing small solid nodules in lung cancer screening: safety and efficacy of a 200 mm(3) minimum size threshold for multidisciplinary team referral |
topic | Brief Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9872225/ https://www.ncbi.nlm.nih.gov/pubmed/36428100 http://dx.doi.org/10.1136/thorax-2022-219403 |
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