Clinical Perspectives


Lung Nodule and Lung Cancer Early Detection

July 26, 2022

Interventional Pulmonology

Early detection of lung cancer is the key to improving the cure rate with lung cancer. 

While over 1.6 million lung nodules are detected on various x-rays annually, most as an incidental finding, over 2/3 of patients don’t receive the proper clinical follow-up or, are overlooked on head and neck or abdominal scans that include part of the thoracic region and incidentally reveal nodules. Subsequently even when identified, over half of clinicians don't follow recognized lung nodule management guidelines which result in an overuse of invasive biopsies, excessive radiographic testing and unnecessary surgery. 38% of needle biopsies are on benign nodules and over 1/3 of nodules removed at surgery are also benign.

The Lung Cancer Early Detection Program at Moffitt is focused on evaluating patients with indeterminant (undiagnosed), newly-discovered lung nodules ranging from 6 mm-50 mm in size.  The Lung Nodule Clinic is run by a thoracic surgeon along with our advanced practice professionals, where we use a standardized approach for patient evaluation including commercial diagnostic biomarkers, validated lung cancer risk algorithms and we carefully follow the Fleischner Society and NCCN lung nodule management guidelines.

It is well established that the larger the cancer, the worse the survival. Therefore, a systematic, organized evaluation of all newly-discovered lung nodules is critical to improve outcomes. All incidentally-discovered lung nodules deserve prompt evaluation since a significant number may be early stage, and likely curable lung cancers.

Lung nodules that have a high probability of malignancy will undergo either invasive diagnostic evaluation (robotic or navigational bronchoscopic biopsy, endobronchial ultrasound or endoesophageal ultrasound-guided biopsy or CT-guided biopsy) or, if appropriate, referral for potential surgical biopsy by one of our five highly-experienced lung cancer surgeons. Nodules deemed low risk will be followed by us according to standard guidelines with prompt written clinical assessments sent regularly to referring physicians.

We believe that our integrated, standardized, and consistent approach will speed up the diagnosis of indeterminant lung nodules, yet prevent unnecessary testing, biopsies, and delays.

We will take full responsibility for the evaluation, treatment (if indicated) and surveillance and follow-up of these lung nodule patients. We feel that this service will allow pulmonologists, oncologists, internists, and family practice physicians the opportunity to have their patients carefully evaluated, promptly treated (if appropriate) and followed as necessary for lung nodules but still allow those patients to continue their regular medical care by their personal community physicians. All too often apparent innocuous lung nodules may get inadvertently lost and patients can easily “fall through the cracks” in any busy practice. Therefore, we are offering this service to our community physicians which we feel will provide a significant benefit to the patients and their doctors.

If you’d like to refer a patient to Moffitt, complete our online form or contact a physician liaison for assistance. As part of our efforts to shorten referral times as much as possible, online referrals are typically responded to within 24 - 48 hours.