HealthDay News — In a CHEST expert panel report, published online April 23 in Radiology: Imaging Cancer, recommendations are presented for the management of pulmonary nodules and lung cancer screening during the COVID-19 pandemic.

Peter J. Mazzone, M.D., M.P.H., from the Respiratory Institute at the Cleveland Clinic, and colleagues reviewed the current evidence to develop consensus statements to guide clinicians managing lung cancer screening programs and patients with lung nodules during the COVID-19 pandemic.

The researchers developed 12 statements relating to baseline and annual lung cancer screening, surveillance of lung nodules, assessment of lung nodules, and management of clinical stage I non-small cell lung cancer. Consistent with U.S. Centers for Disease Control and Prevention guidance to defer nonurgent care, initiation of screening and annual screening exams should be delayed. Surveillance can be delayed for some incidentally detected nodules. For patients with an incidentally detected solid nodule ≥8 mm in diameter with an estimated probability of malignancy of 65 to 85 percent, it is acceptable to assess the patient with a positron emission tomography scan and/or nonsurgical biopsy to ensure there is a need to proceed to treatment. For a patient presenting with an incidentally detected solid nodule of ≥8 mm in diameter with a probability of malignancy estimated at >85 percent, it is acceptable to avoid further diagnostic testing and proceed to an empirical treatment decision.

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“It is important to note that the situation is fluid, and it is not possible at this time to determine when it will be advisable to return to usual care practices,” the authors write.


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