Rate of Incidental Lung Nodule Follow-Up: A Cohort Study Evaluating Adherence to Guideline Recommendations

Background: Solitary pulmonary nodules (SPNs) are commonly identified on imaging studies, and guidelines exist for follow-up. Adherence to guideline recommendations varies. Methods: We conducted a retrospective review at a single center in a metropolitan hospital to identify characteristics of patients with lung nodules and determine the rate of follow-up of these patients. A total of 1266 patient records were reviewed, and 341 patients with solitary pulmonary nodules were identified. Results: The presence of emphysema was associated with an increased rate of follow-up with an odds ratio of 1.9. Of the patients with SPNs, 52% do not receive appropriate follow-up. Of the nodules identified, 40% were noted to be enlarged compared to prior imaging. Conclusions: Identification of SPNs requires a standard approach to ensure follow-up for early detection of potential malignancy. Appropriate follow-up allows improvement of the rate of early cancer detection.